Prevalence, antimicrobial resistance profiles and factors associated with asymptomatic bacteriuria among pregnant women attending Kiswa centre iii, Kampala.

Abstract

Asymptomatic bacteriuria (ABU) is a common clinical condition during pregnancy, associated with significant maternal and fetal complications if untreated. Despite its importance, routine screening and antimicrobial resistance (AMR) profiling remain limited in many low resource settings, including Uganda. The study aimed to determine the prevalence, antimicrobial resistance profiles, and associated risk factors of asymptomatic bacteriuria among pregnant women attending Kiswa Health Center III in Kampala, Uganda.A cross sectional study was conducted from March to August 2024 among 165 pregnant women without urinary tract symptoms. Midstream urine samples were collected and cultured for bacterial isolation. Identification and antibiotic susceptibility testing were performed using standard microbiological techniques and CLSI guidelines. Data on sociodemographic and clinical factors were collected via structured interviews and analyzed using SPSS. The prevalence of ABU was 25.5%, with Escherichia coli being the most frequently isolated pathogen (28%). Other bacteria included Citrobacter freundii, Klebsiella pneumonia, Straphylococcus saprophyticus, and Pseudomonas species. High resistance was observed against ampicillin (64.3%), trimethoptim sulfamethoxale(70.6%), and ciproflaxin (50%). Previous antibiotic use was significantly associated with reduced ABU prevalence (p<0.001) while primigravidity was associated with higher risk (p=0.039). ABU prevalence at KHCIII is high, with multidrug-resistant E.coli being the predominant isolate. Routine urine culture and sensitivity testing should be integrated into antenatal care to ensure early detection and appropriate management. Public health interventions focusing on hygiene education and antimicrobial stewardship are urgently needed especially in rural and public health facilities as they carry a big number of clients and patients from various local communities.