Asymptomatic bacteriuria in pregnancy

Background: The risk of urinary tract infection is higher in pregnancy. Due to lack of symptoms in asymptomatic bacteriuria, patients seldom seek any treatment. If left untreated, it may lead to complications like acute pyelonephritis, preterm labor, low birth weight etc. Adequate and early treatment reduces the incidence of these complications. Aim and Objectives: The objectives of this study were to determine the prevalence of Asymptomatic Bacteriuria (ASB) among pregnant women, evaluate the accuracy of rapid tests in assessing ASB in pregnancy, to know the common causative organisms and their sensitivity pattern and to correlate the demographic data. Material and Methods: One thousand four hundred and ten pregnant women were included in the study. Midstream urine specimen was subjected to semi quantitative culture method and also for urine analysis by microscopy and reagent strip method. Results: Of the 1410 pregnant women, 117(8.3%) had ASB. Sensitivity, specificity, positive and negative predictive value of reagent strip test was good enough when both leukocyte esterase and nitrate test results together or separately were considered positive. E. coli was the commonest organism 65.8 % followed by Klebsiella species 30.7%. Amongst the E. coli, sensitivity to nitrofurantoin, ceftazidime/clavulanic acid and imipenem was found to be 94.1%, 88.2%, and 88.2% respectively. Conclusion: Due to lack of symptoms and harmful consequences in pregnancy, ASB needs special considerations. All the pregnant females should be screened for ASB during pregnancy to prevent maternal and perinatal morbidity. Rapid strip test could be used as an OPD diagnostic test to screen ASB among pregnant women and reserve urine culture for those who turnout positive in screening tests. Wide variation in antibiotic sensitivity pattern of the bacteria causing ASB emphasizes the need of antimicrobial susceptibility testing rather than empirical treatment which is a common practice.