Antibiotic Susceptibility Pattern and Risk Factors Associated With Urinary Infection Among Pregnant Women in Minna, Nigeria

Abstract

Urinary tract infection is a common infection that occurs during pregnancy, often due to anatomical and physiologic changes. This study assesses the prevalence, risk factors and antibiotics susceptibility pattern of uropathogens isolated from pregnant women in Minna. A total of 174 urine samples were examined for the presence of parasites using the centrifugation method and inoculated on nutrient, Salmonella-Shigella, mannitol salt and MacConkey agar for bacteriological analysis. Bacterial identification was based on morphological and biochemical characteristics of isolates. Antibiotic susceptibility was determined using Kirby Bauer's disc diffusion method and extended spectrum beta-lactamase (ESBL) production was screened using double disc synergy test. No parasite was found and bacterial infection was observed in 75/174 (43.1%) of the samples. UTI was more common among patients aged ≥39 years (62.8%), married (43.66%), with no formal education (68.40%), farmers (100.00%) and from rural areas (62.50%). Significant (p<0.05) clinical factors associated with UTI are pains in lower abdomen back or sides, pain or difficulty during urination, frequent urination, vaginal itching and cloudy or smelly urine -- source of water was also a significant risk factor (p=0.0005). The bacterial species isolated were E. coli (38.5%), Staphylococcus sp. (32.1%), Klebsiella sp. (12.8%), Enterobacter sp. (6.4%), Streptococcus sp. (3.8%) and Proteus sp. (2.6%), Pseudomonas aeruginosa (1.3%), Sphingobacterium sp. (1.3%) and Bacillus sp. (1.3%). Gram negative bacteria exhibited high resistant against Cefuroxime (83.7), Augmentin (79.6%), Ceporex (75.5%), Ceftazidime (71.4%) and Streptomycin (51.0%), while Gram-positive bacteria showed moderate resistant against Ceftazidime (48.3%), Streptomycin (44.8%) and Cefuroxime (44.8%). Multidrug resistance was observed in 46.94% and 27.59% of Gram negative and positive bacteria respectively and 2.56% of the isolates were ESBL-producer. The high burden of bacterial UTIs and MDR among isolates emphasize the need for routine UTI screening in antenatal care, this will help to reduce resistance and improve maternal health outcome.