Urinary Tract infection, Drug Resistance Profile and Fetal Outcomes among Pregnant women in Two Health centers and Tikur Anbessa Specialized Hospital , Addis Ababa, Ethiopia.
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Date
2019-06
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Addis Ababa University
Abstract
Background: Urinary tract infection is commonly encountered health problem among pregnant women. Untreated urinary tract infection may result in fetal complications like preterm birth, low birth weight, intra uterine growth retardation, and intrauterine fetal death.
The problem of urinary tract infection is further compounded by the development of drug resistance. Determining drug susceptibility pattern of bacteria from urinary tract helps to identify effective drugs and minimize further adverse perinatal outcomes.
Objective: The objective of this study was to describe the magnitude and drug resistance profile of pregnant women and related fetal outcomes during their third trimester period at Gerji, Felege Meles health centers and Tikur Anbesa Specialized Hospital, Addis Ababa, Ethiopia.
Methods: A cross-sectional study was conducted from March to June 2019. Socio-demographic data of the study participants were collected by administering structured questionnaire after obtaining full consent of the participants. Clean catch mid-stream urine was collected from the study participants and the samples were transported to the Ethiopian Public Health Institute laboratory with screw-capped container. Blood and MacConkey agar was used to culture the urine sample. Bacterial colonies were isolated and identified by their biochemical properties. Antibacterial susceptibility test was done on Muller-Hinton agar using different antibiotic discs and confirmed by VITEK2 Compact machine. At the time of delivery, infant’s birth weight and gestational age was recorded on the log book as part of the daily work. Fetal outcome data required for the study were recorded from the log book and entered to EPI data management software then transferred to SPSS for analysis.
Result: Out of 424 urine samples processed, 63 (14.9%) yielded significant bacteriuria. Out of sixty three samples, fifty nine (93.7%) cases of UTIs were recorded among age group of 15-34years. Escherichia coli, Klebsiella pneumoniae, and Staphylococcus aureus were the three dominant bacterial isolates.
Most of the gram negative bacterial isolates were resistant to ampicillin and ceftazidime (43.2% each) while gram positive were resistant for tetracycline (36.8%). The result of this study showed that UTI had statistically significant association with the occurrence of Intrauterine fetal death (IUFD) and prerupture of membrane (PROM) (P<.05).
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Conclusion: Adverse fetal outcomes are significantly linked with the presence of UTI during pregnancy. The condition can be managed if early diagnosis and treatments are made for the mother. The study highlights that, UTI related adverse fetal outcomes reaches to the level that requires early interventions.
Description
This is to certify that the thesis prepared by Wegayehu Zebene, entitled:
Urinary Tract infection, Drug Resistance Profile and Fetal Outcomes among Pregnant women in Two Health centers and Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia and submitted for partial fulfillment of the requirements for Master of Science degree in Clinical Laboratory Sciences (Diagnostic and Public Health Microbiology) complies with the regulations of the University and meets the accepted standards with respect to originality and quality.
Keywords
UTI, Fetal outcomes, AST, IUFD, APGAR score