Abstract:
Background: Asymptomatic bacteriuria is one of the major risk factors for the development of UTIs
during pregnancy which accounts for about 70% of the cases. If not screened and treated early, it will
proceeds to some complications like pre-eclampsia, symptomatic acute cystitis and acute
pyelonephritis. However, in most of developing countries including Ethiopia, there is no guideline
that recommends routine screening of pregnant women for asymptomatic bacteriuria. There is no
study conducted in in the selected study area to see the magnitude of asymptomatic bacteriuria and
antimicrobial susceptibility pattern of isolates among pregnant women.
Objective: The aim of this study was to determine the magnitude, associated factors and
antimicrobial susceptibility pattern of asymptomatic bacteriuria among pregnant women attending
antenatal care at Hiwot Fana Specialized University Hospital, Harar, Eastern Ethiopia from March to
April 2019.
Methods: A hospital based cross sectional study was conducted on 281 pregnant women selected by
convenient sampling technique. A structured questionnaire was used to collect data from the study
participants and mid-stream fresh urine was used for culture, for isolation and identification of
bacteriuria. Then data were checked and entered into EPI-data version 3.1 and analyzed by Statistical
Package for Social Science software version 22. The results were presented by using frequencies,
percentages, tables and figures. After bivariate and multivariate logistic regression analysis, variables
with a p-value < 0.05 at 95% confidence interval were considered as statistically significant.
Results: The overall prevalence of asymptomatic bacteriuria was 19.9 % (95% CI: 16.4% - 24.6%).
Six different bacterial isolates were identified of which Escherichia coli the most dominant isolate
(44.6%) was followed by Coagulase negative Staphylococci (28.6) and Staphylococcus aureus (10.7
%). Direction of wiping after genital wash (AOR (adjusted odd ratio) = 2.853; 95% CI: 1.255,
4.320), post coital urination (AOR= 3.160; 95% CI: 1.173, 6.514) and catheterization (AOR= 3.122;
95% CI: 1.378, 7.072) were factors significantly associated with asymptomatic bacteriuria.
Escherichia coli were sensitive to ceftriaxone (92.0%), Gentamycin (68.0%) and Augmentin
(60.0%) and Cotrimozazole (68%). The overall drug resistances to two or more than two antibiotics
were observed in 58.9% of isolates.
Conclusion: The overall prevalence of asymptomatic bacteriuria among pregnant women in the
study was higher compared to previous studies conducted in Ethiopia. Direction of wiping after
genital wash, catheterization and post coital urination increases the odds of asymptomatic bacteriuria.
Almost half of the isolates were resistances to two or more than two antibiotics. Pregnant women
should be screened by urine culture and treatment be guided by the antimicrobial susceptibility tests.
In addition to this health education on the predisposing factors is strongly recommended.
