Title: Empirical Treatment of Asymptomatic Bacteriuria (ASB) and Urinary Tract Infection (UTI) in Pregnancy

Authors: Dr Gaurav Tiwari, Dr Ashish Ranjan, Dr G.P. Singh, Dr Deepak Kumar, Dr Satyendra Pathak

 DOI:  https://dx.doi.org/10.18535/jmscr/v6i7.57

Abstract

Objective: Present study was undertaken to determine the prevalence of Asymptomatic Bacteriuria (ASB) and Urinary Tract Infection (UTI) in Pregnancy and to isolate the uropathogens and Drug used as empirical therapy.

Materials and Methods: A total of 260 Pregnant woman attending the Obstetrics & Gynaecology out patients door (GOPD), during routine Antenatal check-up were studied, from all the woman urine sample were collected send for routine examination of urine and Drug Sensitivity Test.

Results: Out of 260 Pregnant woman, 28 (10.76%) Pregnant woman had significant bacteriuria, Insignificant bacteriuria was found in 6 (2.3%) cases, 14 (5.38%) patient had contaminated growth and 212 (81.53%) cases were found culture negative. E. coli was most common isolates accounting 23 (82.14%), Klebsiella spp. and staphylococcus spp. were found in 2 (7.14%) and 2 (7.14%) respectively, only 1 (3.75%) isolates of Enterococcus faecalis was isolated. After Drug sensitivity Tests Amoxycillin, Ampicillin, Cephalexin, Nitrofurantoin, Fosomycin, Ceftriaxone, Cefuroxime and Cefazolin are sensitive and they are also safe in pregnancy.

Conclusion: Asymptomatic bacteriuria is common in Pregnancy. Woman coming for antenatal check-up must be recommended for urine culture and routine examination of urine to prevent the risk of developing symptomatic urinary tract infection, usually in the form of Pyelonephritis. In later pregnancy pyelonephritis increases risk of Pre-term labour (PTL), Low birth weight infants (LBW) and foetal mortality.

Keywords: Pregnancy, Bacteriuria, Pyelonephritis, Low birth weight, Drug Sensitivity.

References

  1. Hooton TM, et al. Urinary tract infections and asymptomatic bacteriuria in pregnancy. Up To Date 4/27/11.
  2. Nicolle LE et al. IDSA Guidelines for the diagnosis and treatment of asymptomatic bacteriuria in adults. CID 205:40 (1 March) 643-654.
  3. Delzell JE Jr, Lefevre ML. Urinary tract infections during pregnancy. AFP Vol 61/No 3, Feb 1, 2000.
  4. Robertson AW, Duff P. The nitrite and leukocyte esterase tests for the evaluation of ASB in OB patients. Obstetrics and Gynaecology. Vol 71, No 6, part 1, June 1988, pp 878-881.
  5. Widmer VJ et al. Duration of treatment for asymptomatic bacteriuria during pregnancy. Cochrane Review 2007.
  6. Smaill F, Vazquez JC. Antibiotics for asymptomatic bacteriuria in pregnancy. Cochrane Review 2007, updated 2009.
  7. Le J, Briggs GG et al. Urinary tract infections during pregnancy. Annals of Pharmacology. Vol 38, No 10, Aug 31 2004, pp 1692-1701.
  8. Guano V, et al. Different antibiotic regimens for treating asymptomatic bacteriuria in pregnancy. Cochrane Review 2010.
  9. Vazquez JC, Abalos E. Treatments for symptomatic urinary tract infection during pregnancy. Cochrane Review 2010.
  10. Bachman JW, Heyse RH, a study of various test to select Asymptomatic urinary tract, Italian obstetric population, JMA 1993, 270 (197-4)
  11. Fatima N, Ishrat S. frequency and risk factor of ASB during pregnancy. J. coli physician surg pak 2006; 16: 273-5.

Corresponding Author

Dr Gaurav Tiwari

Tutor, Department of Pharmacology

Sri Krishna Medical College, Muzaffarpur, India