ABSTRACT

Asymptomatic bacteriuria refers to the presence and multiplication of bacteria in the bladder urine in the absence of symptoms of urinary tract infection. Asymptomatic bacteriuria has been observed to be a strong criterion for urinary tract infection. It is therefore a means of predicting urinary tract infection (UTI). It is common among pregnant women and females. Untreated asymptomatic bacteriuria (ASB) during pregnancy may cause serious complications such as pyelonephritis and delivery of premature or low birth weight infant. This study assessed the prevalence of asymptomatic bacteriuria and the antibiotic susceptibility pattern of the urinary bacterial isolates from pregnant women attending antenatal care clinic at Abia state University Teaching Hospital, Aba, Abia State, Nigeria. Mid-stream urine samples were collected from 100 pregnant women attending antenatal care at Abia state University Teaching Hospital, Aba, Abia State, Nigeria between the ages of 18-49 years. Each specimen was cultured on Cystine Lactose Electrolyte Deficient (CLED) agar using standard bacteriological methods. Identification of suspected colonies and antibiotic sensitivity testing were done. Thirty-eight samples (38) which represent 38.0% showed significant bacteriuria while 62 samples (62.0%) showed no bacteriuria or no significant bacterial growth. Escherichia coli was found to be the most predominant, (36.8%) followed by Proteus spp, (21.1%), Psedomonas aeruginosa (18.4%), Staphylococcus aureus (15.8%) and the least Klebsiella spp. (7.9%). Nitrofurantoin, Ciprofloxacin, Ofloxacin, Gentamicin and Ceftazidime were very effective antimicrobial agents against the isolates while the isolates were highly resistant to Cefexime and Augmentin (Co-amoxiclav). E. coli was the most common bacteria for asymptomatic bacteruria among pregnant women attending antenatal care at Abia state University Teaching Hospital, Aba, Abia State, Nigeria in this study. Education on the importance of inclusion of urine screening in antenatal care should be emphasized.

TABLE OF CONTENTS

Title Page            i

Certification            ii

Dedication            iii

Acknowledgements            iv

Table of Contents             v

List of Tables            vi

List of Figures            vii

Abstract             x

CHAPTER ONE

1.0 Introduction 2

1.1 Aim and objectives 3 

1.1.1 Aim 3

1.1.2 Objectives 3

CHAPTER TWO

2.0 Literature review 5

2.1 Urinary tract infection (UTI) 5

2.2 Asymptomatic bacteriuria 7

2.2.1 Historical aspects 8

2.2.2 Causes and pathogenesis of asymptomatic bacteriuria 9

2.3 Etiology of urinary tract infection 10

2.4 Incidence of urinary tract infection 11

2.5 Epidemiology 12

2.6 Risk factors for asymptomatic bacteriuria 14

2.7 Prevalence of asymptomatic bacteriuria 15

2.8 Classification of urinary tract infection 17

2.8.1 Lower urinary tract infection 17

2.8.2 Upper Urinary Tract Infection 17

2.8.3 Uncomplicated Urinary Tract Infection 17

2.8.4 Complicated Urinary Tract Infection 17

2.9 Outcome of asymptomatic bacteriuria 18

2.10 Complications 18

2.11 Treatment of asymptomatic bacteriuria 22

2.12 Pathogenic organisms causing urinary tract infection 23

2.12.1 Escherichia coli 24

2.12.2 Staphylococcus aureus 24

2.12.3 Klebsiella spp. 24

2.12.4 Pseudomonas spp. 25

CHAPTER THREE

3.0 Materials and method 26

3.1 Study area 26

3.2 Study population 26

3.3 Sample collection 26

3.4 Media preparation 27

3.5 Inoculation and isolation 27

3.6 Identification and characterization of isolates 27

3.6.1 Gram stain technique 27

3.7 Biochemical tests 28

3.7.1 Catalase test 28

3.7.2 Oxidase test 28

3.7.3 Coagulase test

3.7.4 Indole test 28

3.7.4 Citrate utilization test 29

3.7.5 Triple sugar iron agar (TSIA) 29

3.8 Antibiotic sensitivity testing 30

CHAPTER FOUR

4.0 Results 32

CHAPTER FIVE

5.0 Discussion 37

5.1 conclusion 39

5.2 references

Appendix