Antibiotics Susceptibility Study of Uropathogens Isolated from Asymptomatic Pregnant Women Attending a Tertiary Maternity Clinic in Northern Nigeria

Background: Urinary tract infection (UTI) is one of the commonest infections during pregnancy and results in perinatal and maternal morbidity and mortality. For bacterial UTIs, the causative agents have remained virtually the same although with variations in individual prevalence. There has been an increasing resistance by these bacteria to the commonly available antibiotics which has become a serious clinical problem.

Aim: This work was carried out to determine the prevalence of bacterial uropathogens and their antibiotics susceptibility profile among pregnant women attending a tertiary maternity clinic in northern Nigeria.

Methods: A total of 350 pregnant women aged between 21-55 years were enrolled for this study. Mid-stream, clean catch urine samples were cultured on standard bacteriological culture media. Significant bacteriuria was determined by a presumptive test method. Smears of the urine samples were Gram stained and viewed under the oil-immersion objective, and the numbers of bacterial cells per oil-immersion field per millilitre of urine were noted. The resulting isolates from cultures were morphologically and biochemically characterized based on standard procedures and were further confirmed using MicrogenTM GND-ID kits. The antibiotics susceptibility was done using the modified Kirby-Bauer disc agar diffusion method. Statistical package for social sciences (SPSS) version 20 was used for statistical analyses in this study.

Results: Out of 350 urine samples analysed, 83 (23.7%) had significant bacteriuria. The age range of 31-40 years recorded the highest prevalence of 32.5%. Among the isolates, Staphylococcus aureus was the most prevalent (29%) followed by Enterococcus species (22%) and the least uropathogen was Streptococcus pyogenes (3%). Isolated bacteria were resistant to at least two antibiotics with Pefloxacin (55.6%) being highly resisted followed by Ciprofloxacin (50.0%) and Cotrimoxazole (45.6%). Amoxicillin (15.2%), Chloramphenicol (21.1%), Ofloxacin (21.7%), and Amoxicillin –clavulanic acid (29.4%) were more effective against the isolates.

Conclusion: The 23.7% prevalence of bacteriuria and resistance profile of uropathogens to some antibiotics tested in this study is a serious cause for concern. This study showed that uropathogens isolated showed resistance to Pefloxacin (55.6%), Ciprofloxacin (50.0%), and Cotrimoxazole (45.6%) with Stapylococcus aureus showing resistance to more number of antibiotics tested. Routine urine culture and antibiotic susceptibility testing is recommended in pregnancy to identify bacterial causes of urinary tract infections for prompt attention and treatment to avoid complications.