Prevalence, sensitivity patterns and factors associated with asymptomatic bacteriuria among HIV positive pregnant women in Mulago hospital.

Abstract

Background Asymptomatic bacteriuria (ASB) is common during pregnancy. Pregnancy enhances the progression from asymptomatic to symptomatic bacteriuria which could lead to pyelonephritis and adverse obstetric outcomes such as prematurity, low birth weight and higher fetal mortality rates. ASB is a risk factor for acute cystitis (40%) and pyelonephritis (25-30%) in pregnancy. Human immunodeficiency virus (HIV) appears to increase risk for developing significant bacteruria in patients. However the prevalence, sensitivity patterns and factors associated with ASB among HIV positive pregnant women in our setting is unknown. General objective: To determine the prevalence, sensitivity patterns, and factors associated with ASB among HIV pregnant women attending antenatal care in Mulago hospital. Methods: Using a cross-sectional study, HIV Positive Pregnant women not having any symptoms attributable to UTI (dysuria, frequency, and fever) were consecutively invited to participate in the study from January 2012 to March 2012. Clean catch midstream urine was collected in a sterile container and taken for culture and anti microbial sensitivity. Results: The prevalence of ASB among HIV positive pregnant women attending antenatal care in Mulago hospital was 8%. E.coli was the commonest isolate 9(56.25%) and was sensitive to Nitrofurantoin (100%), ceftriaxone (78%) and cefuroxime (67%), and resistant to augmentin (89%) and ampicillin (89%). All bacterial isolates were resistant to cotrimoxazole (100%).Using cotrimoxazole prophylaxis and having CD4 >200 cells/ microlitre were found to be protective against ASB, p values (0.009 and <0.001) respectively. History of sexual intercourse within the past 24 hours was significantly associated with ASB among HIV positive pregnant women.