Detection of asymptomatic Bacteriuria in pregnancy

Background – Pregnant women are at higher risk of urinary tract infections. Urinary tract infections are most commonly occurring infections in pregnancy leading to multiple complications. Asymptomatic bacteriuria is commonly occurring condition in pregnancy. Material and Methods - A total of 200 antenatal women in their first, second or third trimesters were screened over a period of 1 year, for asymptomatic bacteriuria by collecting 20 ml of clean catched mid stream urine samples. The samples were processed in microbiology laboratory as per standard methods and antibiotic sensitivity was done as per CLSI guidelines. 4 screening tests – Gram staining, pus cell counting, catalase test and Greiss nitrite test were done and the sample that gave a positive result was subjected to standard loop method (semi quantitative) and pour plate method (quantitative), for confirmation. Results - Out of 200 cases, 29 were culture positive. A control group of 50 non-pregnant women, both married and unmarried were screened simultaneously. The control group yielded an overall positivity of 6% (8% in married non-pregnant women and 4% in unmarried women). Primigravida had the highest percent culture positivity of 55.1%. E.coli was the most common organism isolated. The organisms were in general sensitive to norfloxacin and cephalexin. Conclusion – Standard loop method was found to be best semi-quantitative method for diagnosis of asymptomatic bacteremia. There was satisfactory agreement between standard loop method and pour plate method. Primigravida had highest incidence of significant bacteriuria.