Prevalence of symptomatic urinary tract infection, microbial isolates and antimicrobial susceptibility patterns among pregnant women attending antenatal care at Kawempe National Referral Hospital..

Abstract

Background: Urinary tract infection (UTI) is the most common infection in women worldwide with an estimated 150 million cases diagnosed with UTI globally per year. It is a major health problem reported among 20% of the pregnant women. Urinary tract infections in pregnancy are classified as either asymptomatic or symptomatic. It causes perinatal and maternal morbidity such as fever, dysuria, frequency, preterm labour, intrauterine growth retardation among others and mortality if untreated. In Kawempe National Referral Hospital there is limited data on the prevalence of symptomatic UTI in pregnancy, microbial isolates and antimicrobial susceptibility patterns. General objective: To determine the prevalence of symptomatic urinary tract infection in pregnancy, bacterial isolates and antimicrobial susceptibility among pregnant women attending antenatal care at Kawempe National Referral Hospital. Methods: This was a cross sectional study conducted at antenatal clinic, Kawempe National Referral Hospital from 2nd June 2021 to 6th July 2021. In this study, 335 systematically sampled women attending ANC at Kawempe National Referral Hospital were included. Using interviewer administered questionnaires, information on socio-demographic, obstetric and clinical characteristics and symptoms suggestive of UTI were collected from the participants. After completion of the interview, the participants with at least one symptom of UTI provided 10-30mls of clean catch mid-stream urine sample in sterile container. The samples were transported to the laboratory within two hours of collection for culture and antimicrobial susceptibility testing. Results: Findings from the study showed that 25.4% (85/335) of the participants had at least one symptom of UTI and had urine culture done. In addition, 29 urine samples had significant microbial growth and therefore 29 isolates were obtained. The prevalence of symptomatic UTI was 8.7% (29/335), 95%CI (6 – 12). Staphylococcus aureus was the commonest isolate at 27.6% (8/29), followed by Enterococcus spp at 24.1% (7/29) and Escherichia coli at 20.7% (6/29). All isolates were resistant to most common antimicrobial with 69% (20/29) of isolates being multidrug resistant. Conclusion: Symptomatic UTI is common among pregnant women attending ANC at Kawempe National Referral Hospital and there was high resistance to commonly used antimicrobials.