Detection of Bacterial Uropathogens and Their Antibiotic Susceptibility Pattern Among Pregnant Women Attending Rajshahi Medical College Hospital

Abstract

Background: A urinary tract infection (UTI) is an infection that canaffect any part of the urinary system and is a major cause for concern for pregnant women. Untreated urinary tract infections during pregnancy have been linked to adverse outcomes for both mother and child, including pyelonephritis, sepsis, septic shock, hypertensive illness of pregnancy, anemia, acute and chronic renal failure, intrauterine growth restriction, premature delivery, foetal mortality, and an increase in the rate at which cesarean sections are performed. Uropathogens may acquire resistance to antibiotics if therapy is not guided by culture and suscepti- bility testing of the patient's urine. Objective: The purpose of this study was to identify uropathogenic bacteria causing urinary tract infection among pregnant women attending at Rajshahi Medical College Hospital and to determine their antibiotic susceptibility pattern. Method: This cross-sectional descriptive study was conducted among pregnant women with clinically suspected UTI, attending the Gynae & Obstetrics depart- ment at Rajshahi Medical College Hospital. The sample size of this study was 294. Urine samples were collected in the early morning and cultured on MacConkey's agar, blood agar, nutrition agar, and chromogenic UTI agar. Overnight incubation at 37 degrees Celsius resulted in a significant bacterial growth when the colony count was at least 105 per milliliter. Then, the modified Kirby Bauer disc diffusion method was used to test for antimicrobial susceptibility, as recommended by the Clinical and Lab- oratory Standards Institute. Results: A total of 294 pregnant moth- ers,114(38.77%) pregnant women were culture positive for UTI. Among the 114 culture positive isolates, single growth of bacteria were 97.36% and multiple growth of bacteria were 2.94%. Gram-negative bacteria were more prevalent (80.34%): Escherichia coli 57(48.71%), Klebsiella spp. 21(17.94%), Pseudomonas spp. 9 (7.69%), Proteus spp. 5 (4.27%) where Gram positive bacteria were 19.65%: Enterococcus spp.11(9.4%), CoNS 7 (5.98%) followed by Staphylococcus aureus 5 (4.27%) respec- tively. Majority of the Gram negative bacterial isolates were sensitive to Meropenem, Nitrofurantoin and Gram positive bacterial isolates were sensitive to Vancomycin and Linezolid respectively. Conclusion: Anti- microbial resistance is on the rise, which poses a problem for treating UTIs. The problem has become more challengingas there are fewer safe antimicrobials available. Regular antenatal checkups should include a urine culture to ensure the health of pregnant women.