ABSTRACT
Studies on
asymptomatic bacteriuria among pregnant women attending antenantal clinic of
the General Hospital Ekwulobia was undertaken, hundred urine samples were
collected then centrifriged and 1ml of the supernatant was inoculated on the
prepared Nutient Agar and Mac Conkey agar then incubated at 370c for
48 hours. Pure colonies were obtained by sub culturing. Morphological and
biochemical characterization of the isolates identified bacteria of the general
Staphylococcus, Streptococcus, Proteus
and Escherichia. The result showed
that 72(72%) of the pregnant women are asymptomatic. E. coli was sensitive to
Reflacine but resistant to Tarivid, Staphylococcusaureus was sensitive to gentamycin
and resistant to Nalidix acid. There is need for routine screening of urine of
pregnant women as part of antenatal health care for pregnant women in Nigeria
CHAPTER ONE
INTRODUCTION
Asymptomatic
bacteriuria refers to the presence of bacteria in Urine. It is a conduction in
which urine reveals a significant growth of pathogens that is greater than 105
bacteria/ml, but without the patient showing symptoms of urinary tract
infection (UTI) (Girbert et al; 2005).
This
common during pregnancy. The apparent reduction in immunity of pregnant women
appears to encourage the growth of both commensal and non-commensal
microorganism (Scott et al; 1990).
The
physiological increase in plasma volume during pregnancy decrease urine
concentration and up to 70% pregnant woman develop glucosurea, which encourage
bacteria growth in urine (Patterson et al; 1987 luces et al; 1993).
Pregnancy
enhances the progression from asymptomatic bacteriuria which could lead to
pyelonephrintis and adverse obstetric
out comes such as prematurity, low birth weight (Connotly et al; 1999)
and higher foetal mortality rates (Nicolle, 1994, Delzell et al; 2000) the
adverse effects of undiagnosed
asymptomatic bacteriuria on mother and child have made researchers to suggest
routine culture screening for all pregnant women attending antenatal clinic
(Kirlam, 2005) in order to prevent mother and child from any form of
complication that may arise due to infection.
However,
in many hospitals in developing countries including Nigeria, routine urine
culture test is not carried out for antenatal patients. Probably due to cost
implication and time factors for culture result (Usually 48 hour’s period)
instead many clinicians opt for the strip urinalysis method for accessing urine
in pregnant women.
The
true picture of such urine specimen cannot be fully accessed as the strip
cannot qualify the extent of infection in such a patient as well as provide
antimicrobial therapy which is usually seen in the case of culture test. In
many health centers in developing countries. The attention of clinicians and
health care providers is usually on the
presence of glucose and protein in urine specimens with less attention on
possible asymptomatic infection.
The
incidence of asymptomatic bacteriuria is reported as 2-4% during pregnancy.
Pregnant women and their unborn foetuses
may be at risk of complication Guyton, 1996, Lindsay, 2003, Bloomberg etal;
2005).
Quantitative
criteria for identifying significant bacteriuria in an asymptomatic person is
at least 100cfu/mc of urine from a catheterized specimen (Warren et al; 1982,
hysky et al; 1987, saint et al; 2003). According to the infections disease
society of America (IDSA) guideline. The diagnosis of asymptomatic bacteriuria
in pregnant women is appropriate only if the same species is present in
quantities at least 10cfu/ml in at least two consecutive voided specimens (Nicolle,
2003, Nicolle et al; 2005).
AIM OF STUDY
Asymptomatic
bacteriuria is common in pregnant women and if untreated could lead to serious
complications. Although asymptomatic bacteriuria could also lead to such
complications, this fact is not well known.
This
study is to determining the prevalence of asymptomative bacteruiria among
pregnant women attending antenatal clinic at the General Hospital Ekwulobia.
SIGNIFICANCE OF STDY
The
importance of this study is to determine the bacterial load, kinds or species
that would be recovered from urine samples of pregnant women attending
antenatal at General Hospital Ekwulobia.
SCOPE OF STUDY
This
study is therefore undertaken to determine the prevalence of asymptomatic
bacteriuria in pregnant women attending antenatal clinic at General Hospital
Ekwulobia and to identify the microorganism involved, determine their relative
proportions and their antibiotic sensitive.