Urinary Tract Infection in Pregnant Women Attending Antenatal Clinic of Tikur Anbessa Specialized Hospital
| dc.contributor.advisor | Asrat, Daniel | |
| dc.contributor.author | Assefa, Addisu | |
| dc.date.accessioned | 2018-07-13T07:02:44Z | |
| dc.date.accessioned | 2023-11-08T16:39:06Z | |
| dc.date.available | 2018-07-13T07:02:44Z | |
| dc.date.available | 2023-11-08T16:39:06Z | |
| dc.date.issued | 2005-06 | |
| dc.description.abstract | Urinary tract infection (UTI) is a common complication of pregnancy. In the majority of the patients, infection appears to be confined to thc lower urinary tract. It may be asymptomatic (asymptomatic bacteriuria), or symptomatic (acute cystitis). All pregnant women, therefore, should have their urine cultured at t heir first visit tot he clinic. T he aim 0 f this study w as to detelmine the prevalence of UTI in pregnant women attending antenatal clinic of T ASH, Addis Ababa, Ethiopia, and to analyze the antimicrobial susceptibility pattern of bacterial uropathogens. A cross-sectional study was conducted on urine specimens collccted from pregnant women attending antenatal clinic of T ASH. Four hundred fourteen pregnant women comprising asymptomatic pregnant women (n=369) and symptomatic prcgnant women (n=4S) were investigated for urinary tract infection from January to March 200S. The age ranges of both groups were 18-44 years, with mean age of 27.1 and 2S.1 years in asymptomatic group and in symptomatic group respectively. Bacteriological screening of mid-stream urine specimen revealed that 3 91}69 (10.6%) and 9/45 (20%) had significant bacteriuria in asymptomatic and symptomatic group, respectively. Thc difference was not statistically significant (p>0.05). The overall prevalence 0 furinary tract infection was 4 8/414 (11.6%). Symptoms did not associate with the prevalence of symptomatic urinary tract infection. Prevalence of urinary tract infection was significantly associated with past history of urinary tract and maternal educational level (p <0.05). Maternal age, marital status, family monthly income, parity, duration of pregnancy, gestational diabetes mellitus and urologic disease or structural 1 functional abnollllalities of urinary tract had no significant association with the prevalence of urinary tract infection during pregnancy. Using urinc culture as gold standard, the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of pyuria in detecting urinary tract infection were 70.8%, 87.2%, 42%, and 9S.6% in overall subjects. The bacterial pathogens isolated were predominantly E. coli 22 (44%), followed by S. aurells 10 (20%), coagulase-negative staphylococci 8 (16%), and K. plleulJlolliae 4 (8%). Others found in small numbers included Envil1ia spp., P. lJIirabilis, P. aemgillosa, A. baulJlallllllii, Ellterococcus spp., and non-Group A B-hemolytic streptococcus accounting for (2%), each. T he l' ates 0 f susceptibility 0 ft he G ramnegatives to antibacterial agents tested ranged from 30-93.3%. Among the Gram-negative more than 65% of the isolates were sensitive to amoxicillin + clavulanic acid (70%), trimethoprim + sulphamethoxazole (73.3%), chloramphenicol (83.3%), nitrofurantoin (87.7%), gentamicin (93.3%), and kanamycin (93.3%). Gram-negative bacteria showed a high rate of resistance to ampicillin, and cephalothin (70%), each. The rates of susceptibility of Gram-positives ranged from 20-100%. Among the Gram-positives, morc than 55% of the isolates were sensitive to kanamycin (60%), trimethoprim + sulphamethoxazole (65%), chloramphenicol (70%), erythromycin (80%), gentamicin (85%), cephalothin (95%), amoxicillin + clavulanic acid (100%), and nitrofurantoin (100%). They, however, showed high rate of resistance to kanamycin (40%), penicillin (75%), and ampicillin (80%). Generally, chloramphenicol, trimethoprim + sulphamethoxazole, amoxicillin + clavulanic acid, gentamicin, kanamycin, and nitrofurantoin were the effective drugs in at least 70% of the isolates. There was also high resistance of the isolates to a mpicillin. A bout 3 7/50 (74%) 0 f t hc isolated pathogens 0 r I 8/30 ( 60%) 0 f G ramnegatives and 19120 (95%) of the Gram-positivcs showed resistance to two or more antimicrobial agents. In the present study, there was a relatively higher prevalence of UTI during pregnancy than previous report in Ethiopia. According to the theoretically 20-40% progression of untreated asymptomatic bacteriuria to symptomatic urinary tract infection, the progression in this study could be 2.1 %- 4.2%. For diagnosis of urinary tract infection during pregnancy especially in casc where culture is unavailable, a combination of microscopic urinalysis of significant pyuria and bacteriuria, and other available tests should be practiced than using a single test. Continuous study on a larger scale is recommended in the future in order to monitor any changes in the sensitivity pattems of pathogens causing urinary tract infection in the pregnant women. Keywords: Urinary tract infection, pregnancy, bacteriuria, prevalence, b acterialu ropathogens, antimicrobial sllsceptibility pattern | en_US |
| dc.identifier.uri | http://etd.aau.edu.et/handle/123456789/8447 | |
| dc.language.iso | en | en_US |
| dc.publisher | Addis Ababa Universty | en_US |
| dc.subject | Urinary tract infection | en_US |
| dc.subject | Pregnancy | en_US |
| dc.subject | Bacteriuria | en_US |
| dc.subject | Prevalence | en_US |
| dc.subject | Bacterial Uropathogens | en_US |
| dc.subject | Antimicrobial sllsceptibility pattern | en_US |
| dc.title | Urinary Tract Infection in Pregnant Women Attending Antenatal Clinic of Tikur Anbessa Specialized Hospital | en_US |
| dc.type | Thesis | en_US |