Urinary Pathogens amongst Parturients at the University of Port Harcourt Teaching Hospital, South-South, Nigeria

Main Article Content

Inye Faye Korubo
Justina Omoikhefe Alegbeleye
Chris Iheanachor Akani

Abstract

Aim: To identify the microorganisms in urine before and after delivery. Also, to identify the incidence, risk factors and antibiotic susceptibility pattern in postpartum bacteriuria.     

Methods: A quasi-interventional study of 50 women who had term vaginal deliveries at the University of Port Harcourt Teaching Hospital (UPTH) Nigeria, between September 1, 2016 and December 31, 2016. Clean catch midstream urine samples collected in sterile containers from parturients before and after delivery were processed. All significant isolates were subjected to antimicrobial susceptibility testing. Socio-demographic data and data regarding labour and risk factors were collected on a pre-designed proforma and entered on a spread sheet. Statistical analysis was done using SPSS version 22.0.

Results: Majority 49 (98%) of the parturients were booked (women that received antenatal care). Eight (16%) of the parturients had bacteriuria pre and post-delivery. Four of the parturients who were negative for bacteriuria before delivery had postpartum bacteria, giving an incidence of 8% for postpartum bacteriuria. The commonest micro-organism isolated post-delivery was Escherichia coli (50%). The number of vaginal examinations, vacuum delivery, episiotomy, perineal tear and bladder catheterization did not significantly increase the risk of postpartum bacteriuria.

Conclusion: Escherichia coli is the most common urinary pathogens and sensitive to Nalidixic acid. Routine screening of women for bacteriuria after delivery and an understanding of the antimicrobial sensitivity will help in reducing associated morbidities.

Keywords:
Asymptomatic bacteriuria, postpartum, antimicrobial, Port Harcourt, Nigeria.

Article Details

How to Cite
Korubo, I. F., Alegbeleye, J. O., & Akani, C. I. (2019). Urinary Pathogens amongst Parturients at the University of Port Harcourt Teaching Hospital, South-South, Nigeria. Asian Journal of Medicine and Health, 17(1), 1-8. https://doi.org/10.9734/ajmah/2019/v17i130156
Section
Original Research Article

References

Duarte G, Marcolin AC, Quintana SM, Cavalli RC. Urinary tract infection in pregnancy. Rev Bras Gynaecol Obstet. 2008;30(2):93–100.

Cheesebrough M. Examination of urine. In: Cheesebrough M (Editor). District Laboratory Practice in Tropical countries. Part 2; Cambridge: Cambridge University Press. 2006;105–114.

Evans DA, Williams DN, Laughlin LW, Miao L, Warren JW, Hennekens CH, et al. Bacteriuria in a population-based cohort of women. J Infect Dis. 1978;138:768–773.

Elram T, Livne A, Oren A, Gross I, Shapiro M, Mankuta D. Mat Fetal Neonat Med. 2008;21(7):483-486.

Hooton TM, Bradley SF, Cardenas DD, Colgan R, Geerlings SE, Rice JC, et al. Diagnosis, prevention, and treatment of catheter-associated urinary tract infection in adults: 2009 International Clinical Practice Guidelines from the Infectious Diseases Society of America. Clin Infect Dis. 2010;50(5):625–663.

Bent S, Nallamothu BK, Simel DL, Fihn SD, Saint S. Does this woman have an acute uncomplicated urinary tract infection? J Am Med Assoc. 2002;287(20): 2701–2710.

Laupland KB, Ross T, Pitout JD, Church DL, Gregson DB. Community-onset urinary tract infections: A population-based assessment. Infection. 2007;35(3):150–153.

Amna MA, Chazan B, Raz R, Edelstein H, Coloner R. Risk factors for non-Escherichia coli community-acquired bacteriuria. Infection. 2013;41(2):473–477.

Ramos NL, Sekikubo M, Dzung DT, Kosnopfel C, Kironde F, Mirembe F, et al. Uropathogenic Escherichia coli isolates from pregnant women in different countries. J Clin Microbiol. 2012;50(11): 3569-3574.

Boucher HW, Talbot GH, Bradley JS, Edwards JE, Gilbert D, Rice LB, et al. Bad bugs, no drugs: no ESKAPE! An update from the Infectious Diseases Society of America. Clin Infect Dis. 2009;48(1):1–12.

Kebira AN, Ochola P, Khamadi SA. Isolation and antimicrobial susceptibility testing of E coli causing UTIs. J Appl Biosci. 2009;22:1320-1325.

Water G, Harrison B, Kuning G. Urinary tract infection. New Engl Med J. 1996;248-250.

Orrett FA, Premanand N. Postpartum surveillance of bacteriuria in term vaginal deliveries. J Nat Med Assoc. 1998;90(3): 177–180.

Younis MN, Abdel-Rahman FM, Khalaf I, Hablas R, Hamed AF. Bacteriuria following vaginal delivery. Int J Gynaecol Obstet. 1983;21:477–479.

Gundersen TD, Krebs L, Loekkegaard ECL, Ramussen SC, Glavind J, Clausen TD. Postpartum urinary tract infection by mode of delivery: A Danish nationwide cohort study. Br Med J Open. 2018;8: e018479.
DOI: 10.1136

Okorondu SI, Akujobi CO, Nnadi CB, Anyado-Nwadike SO, Okorondu MMO. Prevalence and antibiotic sensitivity profile of urinary tract infection pathogens among pregnant and non-pregnant women. Int J Biol Chem Sci. 2013;7(4):1668-1677.

Ronal A. The aetiology of urinary tract infection: Traditional and Emergency Pathogens. Am J Med. 2002;113:145-195.

Lawani EU, Alade T, Oyelaran D. Urinary tract infection amongst pregnant women in Amassoma, Southern Nigeria. Afr J Microbial Res. 2015;9(6):355-359.

Padhi S, Mohanty I, Panda P, Parida B. Antimicrobial resistance in Pathogens causing urinary tract infections in a rural community of Odisha, India. J Fam Comm Med. 2013;20(1):20-26.

Dimitrov TS, Udo EE, Awni F, Emara M, Passadilla R. Etiology and antibiotic susceptibility patterns of community acquired urinary tract infections in a Kuwait Hospital. Med Princ Pract. 2004;13(6):334-339.

Omigie O, Okoror L, Umolu P, Ikuuh G. Increasing resistance to quinolones: A four-year prospective study of urinary tract infection pathogens. Int J Gen Med. 2009; 2:171-175.

Sule-Odu AO, Oluwole AA, Akadri AA, Adeiyi TO, Sotunsa JO, Durojaiye BO. Asymptomatic urinary tract infection among pregnant women in Sagamu, Nigeria. Afr J Online. 2014;6:1-2.

Omonigho SE, Obasi EE, Akukalia RN. In vitro resistance of urinary isolates of Escherichia coli and Klebsiella species to Nalidixic Acid. Niger J Microbiol. 2001; 15(1):25-29.

Akinyele OM, Deji-Agboola AM, Alaka-Coker AA, Adebisi TR, Salako OR, Anorue MC, et al. Antibiotic susceptibility of microorganisms isolated from patients with urinary tract infection in Ibadan south west, Nigeria. Arch Appl Sci Res. 2015;7(7):62-68.

Bouchillon SK, Badal RE, Hoban DJ, Hawser SP. Antimicrobial susceptibility of inpatient urinary tract isolates of gram-negative bacilli in the United States; results from the study monitoring antimicrobial resistance trends (SMART) program. Clin Ther. 2013;35(6):872-877.

Pilout JD, Laupland KB. Extended spectrum beta-lactamase-producing Enterobacteriaceae: An emerging public-health concern. Lancet Infect Dis. 2008;8 (3):159-166.

Tasbakan MI, Pullukcu H, Sipahi OR, Yamazhan T, Ulusoy S. Nitrofurantoin in the treatment of extended-spectrum β lactamase-producing Escerichia coli related lower uterine tract infection. Int J Antimicrob Agents. 2012;40(6):554- 556.

Manjunath GN, Prakash R, Annam V, Shetty K. The changing trends in the spectrum of the antimicrobial drug resistance pattern of uropathogens which were isolated from hospitals and community patients with urinary tract infections in Tumkur and Bangalore. Int J Biol Med Res. 2011;2(2):504-550.

Schwartz MA, Wang CC, Eckert LO, Critchlow CW. Risk factors for urinary tract infection in the postpartum period. Am J Obstet Gynecol.1999;181(3):547–553.

Rehu M, Nilsson CG, Hakkamaa M. Significant bacteriuria in the puerperium: A prospective study of the risk factors. Ann Clin Res. 1980;12(3):112–115.