The document summarizes a study on asymptomatic bacteriuria (ABU) among antenatal women in India. The study found:
1) The prevalence of ABU was 11.5%, with Escherichia coli being the most common organism isolated.
2) Lower socioeconomic status and education level were significant risk factors for ABU.
3) Nitrofurantoin showed the highest effectiveness against bacterial isolates, with a resistance rate of only 3%.
Asymptomatic Bacteriuria among Pregnant Women Attending Antenatal: Evaluation...iosrphr_editor
Introduction: Asymptomatic bacteriuria in pregnancy is common with a prevalence of 2 – 10% and is similar to that observed among non–pregnant women. It is however more likely to progress to symptomatic urinary tract infection during pregnancy because of the physiological changes associated with pregnancy. The value of screening for asymptomatic bacteriuria in pregnancy cannot be over-emphasize, but the kits and methodology need to be evaluated before adoption. Methodology: The study was a prospective, cross sectional, hospital based study. All the subjects were given plastic universal sterile transparent container with screw cap and were enlightened to collect clean catch midstream urine for urinalysis dipstick and microscopy methods using a calibrated wireloop and tested against culture method (which was considered gold standard). RESULT: The urinary strip for nitrite gave a sensitivity of 25.0%, a specificity of 99.1% and a negative predictive value of 90.0% and positive predictive value of 80.0%. From the foregoing the false positive rate was 1.0% while the false negative rate was 10.0%. The efficacy of microscopy method was evaluated as evidence by the presence of pus cells and positive Gram's stain (positive or negative Gram organism) and compared with gold standard culture, sensitivity (true positive) of 81.3%, a specificity of 94.5% was obtained. Conclusion: Microscopy method has appreciable sensitivity and specificity, biochemical methods have low sensitivities but high specificities when compared to the gold standard.
Asymptomatic Bacteriuria among Pregnant Women Attending Antenatal: Evaluation...iosrphr_editor
Introduction: Asymptomatic bacteriuria in pregnancy is common with a prevalence of 2 – 10% and is similar to that observed among non–pregnant women. It is however more likely to progress to symptomatic urinary tract infection during pregnancy because of the physiological changes associated with pregnancy. The value of screening for asymptomatic bacteriuria in pregnancy cannot be over-emphasize, but the kits and methodology need to be evaluated before adoption. Methodology: The study was a prospective, cross sectional, hospital based study. All the subjects were given plastic universal sterile transparent container with screw cap and were enlightened to collect clean catch midstream urine for urinalysis dipstick and microscopy methods using a calibrated wireloop and tested against culture method (which was considered gold standard). RESULT: The urinary strip for nitrite gave a sensitivity of 25.0%, a specificity of 99.1% and a negative predictive value of 90.0% and positive predictive value of 80.0%. From the foregoing the false positive rate was 1.0% while the false negative rate was 10.0%. The efficacy of microscopy method was evaluated as evidence by the presence of pus cells and positive Gram's stain (positive or negative Gram organism) and compared with gold standard culture, sensitivity (true positive) of 81.3%, a specificity of 94.5% was obtained. Conclusion: Microscopy method has appreciable sensitivity and specificity, biochemical methods have low sensitivities but high specificities when compared to the gold standard.
Comparative Study of the Prevalence and Antibiogram of Bacterial Isolates fro...iosrjce
The study compared the prevalence and antibiogram of bacterial isolates from the urinary and
genital tracts of pregnant women attending ante-natal clinics in Imo State. Urine and High vaginal swab (HVS)
samples were collected from across the three geopolitical zones of Imo State (Owerri, Orlu and Okigwe).
Federal Medical Centre (FMC) Owerri, Imo State University Teaching Hospital (IMSUTH) Orlu and General
Hospital Okigwe (GHO) were used as focal points. A total of 1197 samples were obtained from women and
used. Infection was significantly more with the urine samples than the HVS samples (P < 0.05) while
polymicrobial growth was more observed with the HVS samples. Escherichia coli was the predominantly
isolated organism (38.3%) from the urine samples while Staphylococcus aureus (29.1%) was the predominant
bacterial isolates in HVS. Other commonly isolated bacterial species include; Enterococcus faecalis and
Staphylococcus epidermidis, Klebsiella pneumoniae, Proteus mirabilis and Bacteriodes were solely isolated
from urine while Lactobacillus was solely isolated from HVS. Overall antibiogram showed ciprofloxacin to be
the most effective antibiotic followed by nalidixic acid and pefloxac in for both specimens. Generally, multidrug
resistance was more in urine isolates (55.7%) than vaginal isolates (53.6%) with many showing the same
resistance patterns. The rate of multi/drug resistance in both samples is high (>50%) and worrisome. These call
for routine HVS as well as urine culture to be carried out on all antenatal women to ensure holistic antenatal care/ management.
Comparative Study of the Prevalence and Antibiogram of Bacterial Isolates fro...iosrjce
The study compared the prevalence and antibiogram of bacterial isolates from the urinary and
genital tracts of pregnant women attending ante-natal clinics in Imo State. Urine and High vaginal swab (HVS)
samples were collected from across the three geopolitical zones of Imo State (Owerri, Orlu and Okigwe).
Federal Medical Centre (FMC) Owerri, Imo State University Teaching Hospital (IMSUTH) Orlu and General
Hospital Okigwe (GHO) were used as focal points. A total of 1197 samples were obtained from women and
used. Infection was significantly more with the urine samples than the HVS samples (P < 0.05) while
polymicrobial growth was more observed with the HVS samples. Escherichia coli was the predominantly
isolated organism (38.3%) from the urine samples while Staphylococcus aureus (29.1%) was the predominant
bacterial isolates in HVS. Other commonly isolated bacterial species include; Enterococcus faecalis and
Staphylococcus epidermidis, Klebsiella pneumoniae, Proteus mirabilis and Bacteriodes were solely isolated
from urine while Lactobacillus was solely isolated from HVS. Overall antibiogram showed ciprofloxacin to be
the most effective antibiotic followed by nalidixic acid and pefloxac in for both specimens. Generally, multidrug
resistance was more in urine isolates (55.7%) than vaginal isolates (53.6%) with many showing the same
resistance patterns. The rate of multi/drug resistance in both samples is high (>50%) and worrisome. These call
for routine HVS as well as urine culture to be carried out on all antenatal women to ensure holistic antenatal care/ management.
Bacteriuria in Pregnant and Non Pregnant Women in Benghazi Acomparative StudyIOSRJPBS
Background: Bacteriuria is associated with significant maternal and foetal risks. However, its prevalence is not well known in our community. Objectives: Determine the prevalence and predictors of bacteriuria in women of the Benghazi, Libya as well as the antibiotic sensitivity patterns of bacterial isolates. Methods: Across-sectional study was carried out amongst pregnant and non pregnant women attending many poly clinics in Benghazi. We recruited 120 consenting women (60 pregnant and 60 non pregnant) for the study. Demographic and clinical data were collected using structured questionnaire. Clean catch midstream urine was collected from each participant. Samples were examined biochemically, microscopically and by culture. Significant bacteriuria was defined as the presence of 105 bacteria per ml of cultured urine. Identification and susceptibility of isolates was performed using API (BioMerieux, France Company) . Results: Significant bacteriuria was found in the urine of 13.3 % (16) of all women with prevalence of 16.7% in pregnant women. Asymptomatic bacteriuria was detected in 8.3 % (10). The most frequent isolates were Staphylococcus aureus(31.2%),Escherichia coli (25%), Staphylococcus saprophyticus (18.9%), and were sensitive to gentamycin (GN) 87.5%, azithromycin (AZM)75%, and the less effective antibiotics were cephalexine (CL) and ampicillin(AMP) Conclusion: Bacteriuria is frequent in women particularly pregnant women suggesting the need for routine screening by urine culture,which would allow early treatment to avoid the complications. In addition, urinary tract infections appears to be multifactorial.
ABSTRACT- Urinary Tract Infections (UTI) is a major threat to human health. It is caused due to various physiological changes of the urinary tract by the activity of microorganisms. Urinary Tract infections has also been a major type of hospital acquired infection. Hospital acquired infections (HAI) are of various types: Respiratory Tract Infection (RTI), Urinary Tract Infection (UTI), Blood Stream Infection (BSI), and Surgical Site Infection (SSI) and the most common are Urinary Tract (39%) and Respiratory Tract (20-22%) infection. The main aim of this study was to assess various urine samples collected from patients of the ICU of a tertiary care hospital for microbial growth and create a statistical picture on the contribution of UTI to nosocomial infections. Certain governing factors for UTI like presence of pus cells, epithelial cells, and diabetes mellitus were also kept under consideration along with various patient details like age, sex, primary illness and prior antibiotic treatment. The key findings of the study were: the
mean age of patients with symptomatic and asymptomatic UTI was 51 years and people from both genders within the age group of 41-60 were equally susceptible. E. coli was the most common causative organism (35.7%) followed by Citrobacter (21.42%) and Klebsiella (14.28%). Other organisms included Pseudomonas, Enterococcus and Candida. The rate of UTI was 56.22/1000 days of catheterization. Most of the organisms isolated were found to be multi drug resistant. UTI has been hence concluded to play a major contribution in nosocomial infections which needs to be controlled by integrating proper monitoring of hospital data and surveillance of hospital acquired urinary tract infection.
Key-words- ICU, Urinary Tract Infection, Center for Disease Control, Multi drug resistant, antibiotics, Microorganism
Saccharomyces boulardii in the prevention of antibiotic-associated diarrhoea ...Utai Sukviwatsirikul
Saccharomyces boulardii in the prevention of antibiotic-associated
diarrhoea in children: a randomized double-blind placebo-controlled
trial
M. KOTOWSKA, P. ALBRECHT & H. SZAJEWSKA
Department of Pediatric Gastroenterology and Nutrition, The Medical University of Warsaw, Warsaw, Poland
Accepted for publication 24 November 2004
Abstract—The aim of the study was to observe the prevalence of various microorganisms from throat swab specimens in patients attending a tertiary care hospital at Chinakakani, Guntur. Throat swab specimens were collected aseptically from 100 patients and cultured on appropriate bacteriological media. Isolates were identified by biochemical tests & antimicrobial susceptibility performed by standard methods. Out of 100 Samples, culture was positive in 25 samples. So Bacterial infection was found in 25% of Pharyngitis. Streptococcus pyogenes was the commonest isolate, followed by Staphylococcus aureus and Candida albicans. Majority of bacteria were Streptococcus pyogenes, Staphylococcus aureus and Candida albicans. In 60% it was mixed infection. The susceptibility patterns varied depending on the drugs, but most of the organisms were susceptible to penicillin, erythromycin and vancomycin. Improved personal hygiene and health education of the masses on how to care for ear, nose and throat will greatly reduce these microbial infections. This study will be useful for control strategies and for predicting pathogen prevalence in throat swabs.
Comparative Study of Visual, Clinical and Microbiological Diagnosis of White ...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Bacteriological profile of childhood sepsis at a tertiary health centre in so...QUESTJOURNAL
Introduction: Sepsis is a leading cause of morbidity and mortality in children worldwide, even more so in developing countries. Knowledge of common pathogens and their antibiotic susceptibility pattern is useful for guiding initial treatment while awaiting blood culture results. Objective:To determine the major causative organisms and their antibiotic sensitivity pattern of childhood sepsis at the Niger Delta University TeachingHospital (NDUTH), with the aim of revising existing treatment protocols. Methods: Within a 2 year period (1st January 2014 to 31st December 2015) blood culture results of children with clinical suspicion of sepsis were retrospectively studied. Results:During the study period, 116 (12.11%) of the 958 children admitted into the Children Emergency Ward had blood culture tests. Thirty one (26.72%) had positive blood cultures.Eighteen (58.06%) of the organisms were gram positive while thirteen (41.93%) were gram negative. The predominant organism was Staphylococcus aureus in 16 (51.61%) followed by Klebsiella pneumoniae in 5 (16.13%) patients. The bacterial isolates demonstrated the highest sensitivity to the quinolones. Conclusion:There is need for periodic surveillance of the causative organisms and antibiotic susceptibility pattern of childhood sepsis to guide effective management of patients.
El Tratamiento de bacteriuria asintomatica se asocia con alta prevalencia de ...Alex Castañeda-Sabogal
El Tratamiento de la bacteriuria asintomática con antibióticos está asociado con aparición de cepas resistentes a antibióticos!!!! Publicado el 4 de setiembre del 2015 en Clinical Infectious Diseases
Clinicobacteriological study of Urinary tract infection in pregnant womeniosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Role of soluble urokinase plasminogen activator receptor (suPAR) as prognosis...IOSR Journals
Biological marker suPAR was used in many pathological conditions, including infection. suPAR
was correlated with the severity of sepsis. The purpose of this study to determine levels of suPAR infants with
risk of infection as a prognostic indicator for sepsis. Groups of infants with the risk of infection (n = 43) were
followed prospectively on days 0, 3rd and 7th and observed for the incidence of sepsis compared to the control
group (n = 10). suPAR was measured by ELISA and the course of infection measured by clinical criteria.
Results suPAR day 0, 3 and 7, displayed in the form of bloxpot and AUC as prognostic power. suPAR control
levels 9.32 ng / mL, sepsis cutoff 15, 41 ng / mL and AUC of 80.3% [95% CI 65.7%, 94.9%, p = 0.00]. Graph
shows ROC AUC sepsis suPAR day 0, the 3rd and 7th respectively 61.9%, 66.6% and 94.4%. Sepsis with
improved output 16.53 ng / mL and worsening 22.19 ng / mL and AUC of 80.8% [95% CI (0.62 to 0.99), p =
0.02]. suPAR levels was increased in neonatal sepsis patients. suPAR could be used as a prognostic factor for
neonatal sepsis.
Incidence rate of multidrug-resistant organisms in a tertiary care hospital, ...Apollo Hospitals
Antimicrobial resistance to microorganisms is a growing public health concern globally, especially in developing countries. This study was conducted to study the incidence rate of multidrug-resistant organisms with their antibiotic sensitivity pattern.
Seasonal influenza viruses in tropical regions may occur throughout the year, causing outbreaks and epidemics more regularly in humans. There are four types or large groupings of seasonal influenza viruses; Influenza A, B, C, and D, but only influenza A and B viruses cause clinically important human disease and seasonal epidemics. It can cause mild to severe illnesses and even deaths, particularly in high-risk individuals. Vaccination is the most effective means of preventing influenza and its complications. Among healthy adults, influenza vaccine provides protection, even when circulating viruses may not exactly match the vaccine viruses. In elderly, it reduces severity of disease and incidence of complications and deaths. Vaccination is especially important for people at higher risk of serious influenza complications, and for people who live with, care for, high risk individuals.
Introduction: Bloodstream infections (BSIs) are associated with a high mortality rate of 20%-50%. Blood culture is paramount to identify causative agents of BSIs to choose an appropriate antimicrobial therapy. Objectives: The present study was undertaken to analyze the various microorganisms causing BSIs and study their antimicrobial resistance patterns in a tertiary care hospital, Eastern India. Materials and Methods: A total of 239 blood specimens from clinically suspected cases of BSIs were studied for 6 months from July 2015 to December 2015. Blood specimens were incubated in BacT/ALERT ® 3D system (bioMerieux, Durham, NC, USA) a fully automated blood culture system for detection of aerobic growth. Identification and antimicrobial susceptibility testing were conducted on VITEK ® 2 (bioMerieux, Durham, NC, USA) as per Clinical Laboratory Standards Institute guidelines. Results: Out of 239 specimens, 41 (17.2%) yielded growth of different microorganisms. From these isolates, 20 (48.8%) were Gram-negative bacilli, 18 (43.9%) were Gram-positive cocci and rest 3 (7.3%) were yeasts. Among Gram-negative bacilli, Klebsiella pneumoniae sub spp. pneumoniae (70%) was most commonly isolated. Coagulase-negative staphylococci (88.9%) were the most common isolate among Gram-positive cocci. All three Candida spp. isolated were nonalbicans Candida (two Candida tropicalis and one Candida krusei). Gram-negative isolates were least resistant to tigecycline and colistin. All Gram-positive cocci were sensitive to linezolid. Conclusion: Monitoring of data regarding the prevalence of microorganisms and its resistance patterns would help in currently prescribing antimicrobial regimens and improving the infection control practices by formulating policies for empirical antimicrobial therapy.
The title is the main advertisement for an article and enables the reader to decide whether they want to read the article or not. The title should be simple, specific and reflect the article's content clearly and precisely in 10 - 15 words. The abstract summarizes the whole article in 200 to 250 words and should be structured for a research article. It includes the problem or the study objectives, the methods used, the main results obtained and the conclusion reached. Most authors write the abstract last, so that it accurately reflects the content of the article. Keywords are placed below the abstract and are usually 3 - 7 in number. Choosing right keywords will enhance the article being found by other researchers as these are used by abstracting and indexing services. Ultimately, a well-cited research article depends on how well the title, abstract and keywords are written.
Introduction: Clindamycin is an excellent drug for skin and soft tissue Staphylococcus aureus infections, but resistance mediated by inducible macrolide-lincosamide-streptogramin B (iMLS B ) phenotype leads to in vivo therapeutic failure even though they may be in vitro susceptible in Kirby-Bauer disk diffusion method. Objective: The study was aimed to detect the prevalence of iMLS B phenotype among S. aureus isolates by double disk approximation test (D-test) in a tertiary care hospital, Eastern India. Materials and Methods: A total of 209 consecutive S. aureus isolates were identified by conventional methods and subjected to antimicrobial susceptibility testing by Kirby-Bauer disk diffusion method. Erythromycin-resistant isolates were tested for D-test. Results: From 1282 clinical specimens, 209 nonrepeated S. aureus isolates were obtained. Majority of isolates 129 (61.7%) were methicillin-resistant S. aureus (MRSA). There was statistically significant difference between outpatients 60.1% and inpatients 39.9% (P < 0.0001). From 209 S. aureus isolates, 46 (22%) were D-test positive (iMLS B phenotype), 41 (19.6%) were D-test negative (methicillin sensitive [MS] phenotype), and 37 (17.7%) were constitutively resistant (constitutive macrolide-lincosamide-streptogramin B phenotype). The incidence of inducible, constitutive, and MS phenotype was higher in MRSA isolates compared to MS S. aureus (MSSA). The constitutive clindamycin resistance difference between MSSA and MRSA isolates were found to be statistically significant (P = 0.0086). Conclusion: The study revealed 22% of S. aureus isolates were inducible clindamycin resistant, which could be easily misidentified as clindamycin susceptible in Kirby-Bauer disk diffusion method. Therefore, clinical microbiology laboratory should routinely perform D-test in all clinically isolated S. aureus to guide clinicians for the appropriate use of clindamycin.
The world’s biggest multi-sport event summer Olympics Games 2016 officially known as the Games of the XXXI Olympiad, and commonly known as Rio 2016 due to take place Rio de Janeiro, Brazil, from 5th to 21st August, 2016. More than 10,500 athletes from 206 National Olympic committees (NOCs) will take part.[1] These sporting events will take place at 33 venues in the host city Rio de Janeiro and at least 5 venues in the cities of Säo Paulo, Belo Horizonte, Salvador, Manaus and Brazil’s capital Brasilia. International Olympic Committee (IOC) have predicted around 4,80,000 tourists will arrive at Rio de Janeiro for this mega event.[2] Similar to the other tropical countries the tourists will be at risk of acquiring gastrointestinal illnesses and vector-borne infections.
Background and study aim: During last two decades, there has been a world-wide trend in increasing occurrence of enterococcal infections in the hospitals. The aim of present study was to determine the spectrum of enterococcal infections, species prevalence, antimicrobial and characteristics of vancomycin resistant enterococci (VRE) in a tertiary care hospital, Eastern India.
Patients and Methods: Between January 2013 and July 2014, 152 Enterococcus species were obtained from clinical samples. Enterococci were identified using standard biochemical tests. Antimicrobial susceptibility was tested by Kirby-Bauer disk diffusion according to Clinical resistance
& Laboratory Standards Institute (CLSI) guidelines.VRE agar base was used to screen VRE isolates. Minimum inhibitory concentration (MIC) values of VRE isolates were determined using Epsilometer-test. VRE isolates were also examined by PCR to detect vanA gene.
Results: From 1602 clinical samples, 961 (60%) were culture positive and 152 (15.8%) enterococcal isolates were obtained. Most common species isolated was E. faecalis (63.8%) followed by E. faecium (35.5%). Majority of enterococcal infections were detected from ICUs and surgical wards and clinically presented as UTIs. Disk diffusion method showed 67.1% were resistant to penicillin, 61.2% ampicillin, 58.5% ciprofloxacin, 46.7% high-level gentamicin, 42. 8% high-level streptomycin, 7.9% teicoplanin and none to linezolid. Twenty (13.2%) enterococcal isolates were vancomycin resistant in VRE screen and disk diffusion method. Epsilometer-test of VRE isolates showed 8 (40%) isolates were resistant and 9 (45%) were intermediately resistant. From 20 VRE isolates, six showed VanA and two VanB phenotypes and all six VanA phenotypes had vanA gene cluster.
Conclusion: More accurate and reliable MIC determination tests should be performed in all suspected VRE isolates. Confirmatory PCR is required for identifying resistant gene cluster.
Key words: Enterococci, E. faecalis, E. faecium, VRE, vanA gene
Malaria, a protozoan parasitic disease caused by five species of Plasmodium i.e., P. vivax, P. falciparum, P. malariae, P. ovale and P. knowlesi in humans. Nearly half of the world’s population, an estimated 3.3 billion people in 97 countries and territories are at risk of malaria infection and 1.2 billon are at high risk (> 1 case of malaria per 1000 population each year) [1]. According to world malaria report 2014, 198 million cases of malaria occurred globally in 2013 (uncertainty range 124-283 million) and the disease led to 584,000 deaths
(uncertainty range 367,000-755,000) [1]. Among five species of Plasmodium, the most dangerous P. falciparum malaria remains the commonest cause of under-five mortality in several countries [2].
Background & objectives: In Odisha, several cases of dengue virus infection were detected for the first time in 2010, the importance of dengue as a serious mosquito-borne viral infection was felt only in 2011 with the reporting of many more positive cases. This retrospective three year study was done to find out the seroprevalence of dengue Igm antibody and to know the predominant serotype of dengue virus among the patients suspected to have dengue virus infection in a tertiary care hospital in southern Odisha, India.
Methods: Blood samples from clinically suspected dengue cases admitted in the Medicine and Paediatrics departments of a tertiary care hospital were collected. These were processed for detection of dengue specific IgM antibody, carried out by the ELISA method. Dengue IgM antibody positive serum samples were tested for serotypic identification.
Results: of the 5102 samples tested, 1074 (21.05 %) were positive for dengue IgM. Maximum numbers of cases were found in 2012. Majority (47.86 %) of cases were detected in the month of September. The most common affected age group was 11 to 20 yr. DENV1 and DENV2 were the detected serotypes.
Interpretation & conclusions: Rapid increase in the dengue cases in 2012 became a public health concern as majority of cases were affecting the young adolescents. Most of the cases were reported in post-monsoon period indicating a need for acceleration of vector control programmes prior to arrival of monsoon.
Key words Dengue virus - IgM antibody - seroprevalence - serotype - vector control
ABSTRACT
Background: With the advances in medical care, invasive fungal
infections possess a significant health problem especially in
immunocompromised patients. These infections have varied aetiological
agents which are commonly found in soil, water, plant debris and organic
substrates. Aim: The overview of different fungal aetiological agents,
newer and rapid diagnostic modalities and overall treatment and
prevention options available is presented in this article. Methods:
Literature search was performed in PubMed by using MeSH terms
‘mycoses’ and ‘immunocompromised host’. Only relevant review articles
published within the last five years were considered. Google Scholar
search engine was also used. Results: Common invasive fungi include
Candida spp., Cryptococcus spp., Aspergillus spp., Trichosporon spp.,
Rhodotorula spp., Fusarium spp., Mucormycotina, Pheohyphomycosis
spp., Pneumocystis jirovecii, Scedosporium spp., and endemic mycoses
such as Penicillium, Histoplasma and Blastomyces. A high degree of
suspicion is required for early diagnosis and optimal management of these
infections. Conclusion: Early and rapid diagnosis of causative fungal
agents is required so that appropriate treatment can be initiated. Adequate
preventive measures must be applied in an immunocompromised host that
can prevent development of drug resistant super-infections.
Health Education on prevention of hypertensionRadhika kulvi
Hypertension is a chronic condition of concern due to its role in the causation of coronary heart diseases. Hypertension is a worldwide epidemic and important risk factor for coronary artery disease, stroke and renal diseases. Blood pressure is the force exerted by the blood against the walls of the blood vessels and is sufficient to maintain tissue perfusion during activity and rest. Hypertension is sustained elevation of BP. In adults, HTN exists when systolic blood pressure is equal to or greater than 140mmHg or diastolic BP is equal to or greater than 90mmHg. The
CRISPR-Cas9, a revolutionary gene-editing tool, holds immense potential to reshape medicine, agriculture, and our understanding of life. But like any powerful tool, it comes with ethical considerations.
Unveiling CRISPR: This naturally occurring bacterial defense system (crRNA & Cas9 protein) fights viruses. Scientists repurposed it for precise gene editing (correction, deletion, insertion) by targeting specific DNA sequences.
The Promise: CRISPR offers exciting possibilities:
Gene Therapy: Correcting genetic diseases like cystic fibrosis.
Agriculture: Engineering crops resistant to pests and harsh environments.
Research: Studying gene function to unlock new knowledge.
The Peril: Ethical concerns demand attention:
Off-target Effects: Unintended DNA edits can have unforeseen consequences.
Eugenics: Misusing CRISPR for designer babies raises social and ethical questions.
Equity: High costs could limit access to this potentially life-saving technology.
The Path Forward: Responsible development is crucial:
International Collaboration: Clear guidelines are needed for research and human trials.
Public Education: Open discussions ensure informed decisions about CRISPR.
Prioritize Safety and Ethics: Safety and ethical principles must be paramount.
CRISPR offers a powerful tool for a better future, but responsible development and addressing ethical concerns are essential. By prioritizing safety, fostering open dialogue, and ensuring equitable access, we can harness CRISPR's power for the benefit of all. (2998 characters)
Telehealth Psychology Building Trust with Clients.pptxThe Harvest Clinic
Telehealth psychology is a digital approach that offers psychological services and mental health care to clients remotely, using technologies like video conferencing, phone calls, text messaging, and mobile apps for communication.
Global launch of the Healthy Ageing and Prevention Index 2nd wave – alongside...ILC- UK
The Healthy Ageing and Prevention Index is an online tool created by ILC that ranks countries on six metrics including, life span, health span, work span, income, environmental performance, and happiness. The Index helps us understand how well countries have adapted to longevity and inform decision makers on what must be done to maximise the economic benefits that comes with living well for longer.
Alongside the 77th World Health Assembly in Geneva on 28 May 2024, we launched the second version of our Index, allowing us to track progress and give new insights into what needs to be done to keep populations healthier for longer.
The speakers included:
Professor Orazio Schillaci, Minister of Health, Italy
Dr Hans Groth, Chairman of the Board, World Demographic & Ageing Forum
Professor Ilona Kickbusch, Founder and Chair, Global Health Centre, Geneva Graduate Institute and co-chair, World Health Summit Council
Dr Natasha Azzopardi Muscat, Director, Country Health Policies and Systems Division, World Health Organisation EURO
Dr Marta Lomazzi, Executive Manager, World Federation of Public Health Associations
Dr Shyam Bishen, Head, Centre for Health and Healthcare and Member of the Executive Committee, World Economic Forum
Dr Karin Tegmark Wisell, Director General, Public Health Agency of Sweden
One of the most developed cities of India, the city of Chennai is the capital of Tamilnadu and many people from different parts of India come here to earn their bread and butter. Being a metropolitan, the city is filled with towering building and beaches but the sad part as with almost every Indian city
Explore our infographic on 'Essential Metrics for Palliative Care Management' which highlights key performance indicators crucial for enhancing the quality and efficiency of palliative care services.
This visual guide breaks down important metrics across four categories: Patient-Centered Metrics, Care Efficiency Metrics, Quality of Life Metrics, and Staff Metrics. Each section is designed to help healthcare professionals monitor and improve care delivery for patients facing serious illnesses. Understand how to implement these metrics in your palliative care practices for better outcomes and higher satisfaction levels.
Deep Leg Vein Thrombosis (DVT): Meaning, Causes, Symptoms, Treatment, and Mor...The Lifesciences Magazine
Deep Leg Vein Thrombosis occurs when a blood clot forms in one or more of the deep veins in the legs. These clots can impede blood flow, leading to severe complications.
Antibiotic Stewardship by Anushri Srivastava.pptxAnushriSrivastav
Stewardship is the act of taking good care of something.
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
WHO launched the Global Antimicrobial Resistance and Use Surveillance System (GLASS) in 2015 to fill knowledge gaps and inform strategies at all levels.
ACCORDING TO apic.org,
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
ACCORDING TO pewtrusts.org,
Antibiotic stewardship refers to efforts in doctors’ offices, hospitals, long term care facilities, and other health care settings to ensure that antibiotics are used only when necessary and appropriate
According to WHO,
Antimicrobial stewardship is a systematic approach to educate and support health care professionals to follow evidence-based guidelines for prescribing and administering antimicrobials
In 1996, John McGowan and Dale Gerding first applied the term antimicrobial stewardship, where they suggested a causal association between antimicrobial agent use and resistance. They also focused on the urgency of large-scale controlled trials of antimicrobial-use regulation employing sophisticated epidemiologic methods, molecular typing, and precise resistance mechanism analysis.
Antimicrobial Stewardship(AMS) refers to the optimal selection, dosing, and duration of antimicrobial treatment resulting in the best clinical outcome with minimal side effects to the patients and minimal impact on subsequent resistance.
According to the 2019 report, in the US, more than 2.8 million antibiotic-resistant infections occur each year, and more than 35000 people die. In addition to this, it also mentioned that 223,900 cases of Clostridoides difficile occurred in 2017, of which 12800 people died. The report did not include viruses or parasites
VISION
Being proactive
Supporting optimal animal and human health
Exploring ways to reduce overall use of antimicrobials
Using the drugs that prevent and treat disease by killing microscopic organisms in a responsible way
GOAL
to prevent the generation and spread of antimicrobial resistance (AMR). Doing so will preserve the effectiveness of these drugs in animals and humans for years to come.
being to preserve human and animal health and the effectiveness of antimicrobial medications.
to implement a multidisciplinary approach in assembling a stewardship team to include an infectious disease physician, a clinical pharmacist with infectious diseases training, infection preventionist, and a close collaboration with the staff in the clinical microbiology laboratory
to prevent antimicrobial overuse, misuse and abuse.
to minimize the developme
1. ISSN 2278-960X
JOURNAL OF
BASIC and CLINICAL
REPRODUCTIVE SCIENCES
Official Publication of the Society of Reproductive Biologist of Nigeria
Volume 2 / Issue 2 / July - December 2013
www.jbcrs.org
2. Original Article
Prevalence, Risk Factors and Antimicrobial Resistance of Asymptomatic
Bacteriuria Among Antenatal Women
Muktikesh Dash, Susmita Sahu, Indrani Mohanty, Moningi Venkat Narasimham, Jyotirmayee Turuk, Rani Sahu
Department of Microbiology, Maharaja Krishna Chandra Gajapati Medical Collage and Hospital, Berhampur University, Berhampur, Odisha, India
A b s t r a c t
Background: Asymptomatic bacteriuria (ABU) in antenatal women is microbiological diagnosis and if untreated have 20‑30
fold increased risk of developing pyelonephritis during pregnancy. Aim: The prospective study was conducted to determine
the prevalence, risk factors and antibiotic resistance related to ABU in antenatal women. Subjects and Methods: A total of
287 asymptomatic pregnant women who attended the antenatal clinic at a tertiary care hospital, Odisha, India from July 2012
to December 2012 were enrolled. Two consecutively voided urine specimens were collected by clean‑catch midstream urine
technique for culture. The urine samples were processed and microbial isolates were identified by conventional methods.
Antimicrobial susceptibility testing was performed on all bacterial isolates by Kirby Bauer’s disc diffusion method. Data were
analyzed using GraphPad Quick Calcs Statistical Software Inc., USA. Inferential statistics was done by Chi‑square (χ2) test and a
P < 0.05 was considered significant. Results: The prevalence of ABU in antenatal women was 11.5% (33/287). Lower socio‑economic
status and low level of education were significant risk factors related to ABU (P=0.02). Parity, maternal and gestational age was
not significantly associated with ABU. Escherichia coli (54.5%, 18/33) were the most prevalent isolate followed by Enterococcus
faecalis (15.2%, 5/33). Nitrofurantoin was the most effective antibiotic, showed resistance rate of 3% (1/33) for both Gram‑negative
and Gram‑positive bacteria. Conclusion: Routine screening using urine culture method should be performed for ABU in early
pregnancy. Specific guidelines should be issued and followed for testing antimicrobial susceptibility with safe drugs in antenatal
women. Empirical treatment with nitrofurantoin can be recommended, which is a safe drug and active for both Gram‑negative
and Gram‑positive bacteria.
KEY WORDS: Antenatal women, antibiotic resistance, asymptomatic bacteriuria, prevalence, risk factors
INTRODUCTION
Urinary tract infection (UTI) during pregnancy is classified as
either symptomatic or asymptomatic. Symptomatic UTI are
divided into lower tract (acute cystitis) and upper tract (acute
pyelonephritis) infection. Asymptomatic bacteriuria (ABU),
generally defined as true bacteriuria in the absence of
specific symptoms of acute UTI. The prevalence of ABU
among antenatal women varies between 2% and 10%.[1] The
anatomical and physiological changes imposed on urinary
tract by pregnancy, as well as pressure on ureters by the
gravid uterus and the muscle relaxant effect of progesterone,
predisposes women with ABU to UTI.[2] Women identified
with ABU in early pregnancy have 20‑30 fold increased risk
of developing pyelonephritis during pregnancy, compared
with women without bacteriuria.[3] These women also are
more likely to experience premature delivery and to have
infants with low‑birth weight.
Escherichia coli remains the single most common organism
isolated from bacteriuric women, other organisms including
Klebsiella pneumoniae, coagulase‑negative Staphylococci,
Enterococcus spp., group B Streptococci and Gardnerella
vaginalis are common as well.[4] Gestational diabetes,
past history of UTI, multiparity, advanced maternal age,
advanced gestational age, lower education level and lower
socio‑economic status have been documented as risk
factors in some of the studies and conflicting results have
been obtained from different studies.[5,6]
Quantitative urine culture is the gold standard for diagnosis
of ABU. Prospective, comparative clinical trials have reported
Address for correspondence
Dr. Muktikesh Dash,
Department of Microbiology, Maharaja Krishna Chandra Gajapati Medical
Collage and Hospital, Berhampur University,
Berhampur ‑ 760 004, Odisha, India.
E‑mail: mukti_mic@yahoo.co.in
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DOI:
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92 Journal of Basic and Clinical Reproductive Sciences · July - December 2013 · Vol 2 · Issue 2
3. Dash, et al.: Asymptomatic bacteriuria among antenatal women
that antimicrobial treatment of ABU during pregnancy
decreases the risk of subsequent pyelonephritis from 20‑30%
to 1‑4% and decreases the frequency of low‑birth weight
infants and preterm delivery.[7,8] Therefore, all antenatal
women requires screening for bacteriuria by urine culture
at least once in early pregnancy so that they can be treated
with appropriate antibiotics for 3‑7 days.[9] Antimicrobial
agents including selective ß‑lactams, nitrofurantoin,
quinolones and co‑trimoxazole can be considered during
pregnancy.[10] However, the emergence of drug resistance,
limits the choice of antibiotics.
To the best of our knowledge, no information is available
from Odisha state, India on the prevalence of ABU in
antenatal women. Hence, this prospective study was
designed to determine the prevalence of ABU, etiological
agents, risk factors and antimicrobial resistance patterns
in antenatal women who attended a tertiary care hospital,
Odisha, India.
SUBJECTS AND METHODS
Study area
The present prospective study was carried out in the clinical
Microbiology laboratory of a tertiary care hospital, which is
located in southern Odisha, India. The duration of the study
was 6 months period from July 2012 to December 2012.
Study population
A total of 287 women in their first, second and third
trimester of pregnancy, in the age group of 20‑40 years
who attended the antenatal clinic for the first time of our
hospital were assessed for ABU. For asymptomatic pregnant
women, bacteriuria is defined as two consecutive voided
urine specimens with isolation of the same bacterial
strain in quantitative counts ≥105 colony forming units
per milliliter (cfu/mL).[9] Inclusion criteria included those
pregnant women who consented to give two consecutive
urine samples on the first antenatal visit. Exclusion
criteria included: (a) Non‑pregnant women, (b) signs and
symptoms of UTI and (c) antibiotics usage within week.
Demographic data, medical and social information as well
as gynecological and obstetrics history of the subjects were
obtained from pre‑tested, self‑administered questionnaire.
The study was conducted after approval from Institutional
Ethical Committee.
Sample collection and processing
On each antenatal visit, two consecutive freshly voided
clean‑catch midstream urine samples were collected from
antenatal woman in a sterile wide mouth screw‑capped
universal container with aseptic precautions in the antenatal
clinic. The specimens were labeled and transported to the
microbiology laboratory for processing within 2 h.
Semi‑quantitative urine culture was done using a calibrated
loop. A loopful (0.001 mL) of well mixed un‑centrifuged
urine was inoculated onto the surface of cysteine lactose
electrolyte deficient medium. The culture plates were
incubated aerobically at 37°C for 18‑24 h and count were
expressed as cfu/mL. For this study, significant bacteriuria
was defined as culture of a single bacterial species from
two consecutive urine samples at a concentration of
≥105 cfu/mL.[11] Only patients with significant bacteriuria
(≥105 cfu/mL) were included for microbiological analysis. The
culture isolates were identified by standard microbiological
methods.[12] All culture media were procured from HiMedia
Laboratories, Mumbai, India.
Antimicrobial susceptibility testing
Isolates were tested for antimicrobial susceptibility
testing by the standard Kirby‑Bauer disc diffusion method
according to Bauer et al.[13] Mueller‑Hinton agar plates
were incubated for 24 h after inoculation with organisms
and placement of discs. After 24 h the inhibition zones
were measured. The following standard antibiotic discs for
the isolates were used; ampicillin 10 micrograms (mcg),
amoxicillin (10 mcg), amoxicillin/clavulinic acid (20/10 mcg),
nitrofurantoin (300 mcg), cephalexin (30 mcg), cefuroxime
(30 mcg) ciprofloxacin (5 mcg) and norfloxacin (10 mcg).
Antibiotic discs were obtained from HiMedia Laboratories,
Mumbai, India. The results were interpreted according to
Clinical and Laboratory Standards Institute guidelines.[14]
The quality control strains used were E. coli ATCC 25922
and Enterococcus faecalis ATCC 29212 for antimicrobial
discs.
Statistical analysis
The data were analyzed using GraphPad Quick Calcs
Statistical Software Inc., USA. Inferential statistics was
done by Chi‑square (χ2) test and a P < 0.05 was considered
significant.
RESULTS
The mean age of antenatal women who attended antenatal
clinic and participated the study was 25.87 (5.2) years
(median 24, minimum 20 and maximum 40 years). Out of
total 287 antenatal women examined for ABU, 33 were
positive for significant bacteriuria; thus showed a prevalence
of 11.5% (33/287).
Table 1 shows the socio‑economic characteristics of the study
subjects by age, level of education, socio‑economic status,
estimated gestational age and parity. Majority (241/287,84%)
of subjects were between the age group of 20 and
30 years, showed a prevalence of 11.2%(27/241). Similarly,
majority (54.4%, 156/287) of the subjects were multipara
and presented in 2nd and 3rd trimester of pregnancy (61%,
Journal of Basic and Clinical Reproductive Sciences · July - December 2013 · Vol 2 · Issue 2 93
4. Dash, et al.: Asymptomatic bacteriuria among antenatal women
Table 1: Socio‑demographic characteristics by the distribution of study subjects
Variables Total no. of urine specimen collected from antenatal women Chi‑square value P value
No. tested (%) UTI absent (%) UTI present (%)
Age in years
20‑30 years 241 (84) 214 (88.8) 27 (11.2) 0.01 0.91
31‑40 years 46 (16) 40 (87) 06 (13) (NS)
Level of education
Up to primary level 195 (67.9) 167 (85.6) 28 (14.4) 4.05 0.04
College and higher 92 (32.1) 87 (94.6) 05 (5.4) (S)
Socio‑economic status
Low 179 (62.4) 152 (84.9) 27 (15.1) 5.11 0.02
High 108 (37.6) 102 (94.4) 06 (5.6) (S)
Gestational age
<13 weeks (1st trimester) 112 (39) 104 (92.9) 08 (7.1) 2.76 0.09
≥13 weeks (2nd and 3rd trimester) 175 (61) 150 (85.7) 25 (14.3) (NS)
Parity
Primigravida 131 (45.6) 120 (91.6) 11 (8.4) 1.75 0.18
Multipara 156 (54.4) 134 (85.9) 22 (14.1) (NS)
UTI – Urinary tract infection; P<0.05 (statistically significant); S – Significant; NS – Not significant; (n=287)
Table 2: Prevalence of uropathogens among asymptomatic
antenatal women in a tertiary care hospital, Odisha, India
Gram reaction Microorganism Number Percentage
Gram‑negative bacteria Escherichia coli 18 54.5
Klebsiella pneumoniae 02 6.1
Citrobacter freundii 02 6.1
Proteus mirabilis 01 3
Gram‑positive bacteria Enterococcus faecalis 05 15.2
Staphylococcus saprophyticus 04 12.1
Staphylococcus epidermidis 01 3
Total number of bacteria
(both Gram‑negative and
Gram‑positive)
33 100
(n=33)
175/287), had revealed prevalence of 14.1% (22/156) and
14.3% (25/175) respectively. These variables did not show
statistically significant results. Evaluation of significant
bacteriuria in relation to the level of education and
socio‑economic status showed significant association with
low level of education and lower socio‑economic status.
The frequency of microorganisms isolated is shown in
Table 2. From total 33 significant bacteriuria isolates,
Gram‑negative bacteria accounted for 69.7% (23/33), while
Gram‑positive bacteria accounted for 30.3%(10/33). E. coli
(54.5%, 18/33) was the most frequently isolated bacteria,
followed by E. faecalis (15.2%, 5/33), The antibiotic resistance
profiles of the bacterial isolates are summarized in Table 3.
Overall, Gram‑negative isolates showed higher resistance
pattern in comparison to Gram‑positive. Nitrofurantoin was
the most effective antibiotic for both Gram‑negative and
Gram‑positive bacteria, showed resistance rate of 3% (1/33),
followed by ciprofloxacin 30.3% (10/33) and amoxicillin/
clavulinic acid 36.4% (12/33).
DISCUSSION
ABU in antenatal women is a microbiologic diagnosis
determined with a gold standard urine culture for significant
bacteriuria during their 1st antenatal visit preferably at
the end of 1st trimester.[10] This present study provides
valuable laboratory data to know the prevalence of ABU
among antenatal women, to study their socio‑demographic
profiles, to monitor the status of antibiotic resistance in
uropathogens and to improve treatment recommendations
in a specific geographic region. This study also allows
comparison of the situation in Odisha state with other
regions within and outside India.
From total 287 urine samples collected from asymptomatic
antenatal women and tested, 33 yielded significant
uropathogens thus showed a prevalence of 11.5% (33/287).
This correlates with the global prevalence of ABU among
antenatal women, which varies between 2% and 10%. Similar
prevalence of ABU 9.8%, 11.2%, 13.7% and 16% among antenatal
women was reported by Marahatta et al. in Kathmandu,
Nepal, Chitralekha et al. in Chennai, India, Saeed and Tariq
in Karachi, Pakistan and Ansari and Rajkumari in Hyderabad,
India respectively.[15‑18] Low prevalence rate of 6.1% and 7.5%
was observed by Ahmad et al. in Kashmir, India and Saraswathi
and Aljabri in Hyderabad, India.[19,20] High prevalence of 29.1%,
38.3% and 45.3% was revealed by Rahimkhani et al. in Tehran,
Iran, Rizvi et al. in Aligarh, India and Imade et al. in Benin city,
Edo state, Nigeria respectively.[21‑23] Geographical location
and varied distribution of microorganisms may be the reason
for this wide difference in prevalence.
In our study, majority of the bacteriuric women belonged
to lower socio‑economic status and they studied up to
primary level. The ABU was significantly associated among
them (P < 0.05). The close association between ABU, low
socio‑economic status and low level of education has been
documented by various researchers.[24‑27] This association
may be due to poor knowledge and practice of personal
hygiene in pregnancy. Another reason could be as a result
of poor genital hygiene practices by antenatal women
who may find it difficult to clean their anus properly after
defecating or clean their genital after passing urine.[23]
94 Journal of Basic and Clinical Reproductive Sciences · July - December 2013 · Vol 2 · Issue 2
5. Dash, et al.: Asymptomatic bacteriuria among antenatal women
Table 3: Resistance patterns of Escherichia coli, Gram‑negative isolates and Gram‑positive isolates
Antibiotic (μg) Number (%) of isolates resistant
among Escherichia coli (n=18)
Number (%) of isolates resistant among all
Ampicillin (10) 17 (94.4) 05 (100) 06 (60)
Amoxicillin (10) 17 (94.4) 05 (100) 06 (60)
Amoxicillin/clavulinic acid (20/10) 08 (44.4) 02 (40) 02 (20)
Nitrofurantoin (300) 01 (5.6) 0 0
Cephalexin (30) 10 (55.6) 02 (40) 03 (30)
Cefuroxime (30) 09 (50) 01 (20) 03 (30)
Norfloxacin (10) 16 (88.9) 04 (80) 07 (70)
Ciprofloxacin (5) 07 (38.9) 01 (20) 02 (20)
In the present study, prevalence of 11.2% was recorded in
the age group of 20‑30 years and 13% among 31‑40 age
groups. No relationship between prevalence of ABU and
patient’s age group was found (P = 0.91). Similar findings
were obtained in previous studies.[24,26,28] Advanced maternal
age (≥35 years) was reported as risk factor for ABU in
pregnancy.[5]
There was no significant difference in the prevalence of ABU
with respect to trimester and parity in our study (P = 0.09
and 0.18 respectively). This agrees with earlier studies.[23,27]
It has been reported that advanced gestational age and
multipara are risk factors for acquiring ABU in pregnancy.[18,24]
In our study, Gram‑negative aerobic bacteria predominated
(69.7%), among which E. coli was the most prevalent
uropathogens, followed by E. faecalis (15.2%) and
S. saprophyticus (12.1%). There is increase in prevalence of
Enterococcus spp. and S. saprophyticus have been reported
by various authors in different studies.[21,29‑31] The data
collected from different places around the world showed
that E. coli and Klebsiella spp. are still commonest pathogens
in ABU.[15,16,19,22] Gram‑negative aerobic bacteria including
Enterobacteriaceae have several factors responsible for
their attachment to uroepithelium. They colonize in the
urogenital mucosa with adhesin, pili, fimbriae and P‑1 blood
group phenotype receptor.[32]
Treatment of ABU has been shown to reduce the rate of
pyelonephritis in later part of pregnancy and therefore
regular screening for and appropriate treatment of
ABU has become a standard of obstetrical care.[33] The
antibiotic chosen for antenatal women should have
a good maternal and fetal safety profile, excellent
efficacy and low resistance rate. United States food
and drug administration, category B drugs including
ampicillin, amoxicillin, amoxicillin/clavulinic acid,
cephalexin, cefuroxime and nitrofurantoin and category
C drugs including ciprofloxacin, norfloxacin, levofloxacin
and co‑trimoxazole should be used as empirical
therapy for both ABU and symptomatic UTI during
pregnancy.[10] However, local antibiotic susceptibility
patterns must be taken into account before choosing an
agent due to increasing antibiotic resistance prevalent
Gram‑negative isolates (n=5)
Number (%) of isolates resistant among all
Gram‑positive isolates (n=10)
for the population in question. In this present study,
Gram‑negative isolates showed higher resistance pattern
in comparison to Gram‑positive isolates. Gram‑negative
isolates including E. coli showed high level of resistance
pattern to ampicillin, amoxicillin, norfloxacin, cephalexin,
cefuroxime, amoxicillin/clavulinic acid and ciprofloxacin.
Nitrofurantoin was found to be single most effective drug
for both Gram‑negative and Gram‑positive bacteria, showed
resistant rate of 3%. Similar resistance pattern was reported
from studies conducted in different parts of India and its
neighboring countries.[15,30,31,34] Irrational prescription of
antibiotics which are available over‑the‑counter in India
and indiscriminate use has created has created a high
level of drug resistance. Our findings thus suggest that
empirical treatment with commonly used antibiotics
except nitrofurantoin should no longer be appropriate.
This study was limited by less sample size and some of the
study subjects attended antenatal clinic late, i.e., in their 2nd
and 3rd trimester of pregnancy was included.
CONCLUSION
Our study showed prevalence rate of ABU among antenatal
women was 11.5%. Nitrofurantoin was the most effective
antibiotic for both Gram‑negative and Gram‑positive
bacteria with resistance rate of <10%. Therefore, it
is important to screen all antenatal women with gold
standard urine culture for significant bacteriuria during
their 1st antenatal visit preferably at the end of 1st trimester.
This should be followed with antibiotic susceptibility for
determining therapy as inappropriate or no therapy has
been responsible for recurrences of ABU and subsequent
development of acute pyelonephritis. Thus empirical
treatment of ABU may not apply for specific geographical
regions, where decreased susceptibility rates to commonly
used antibiotics have been documented for uropathogens.
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How to cite this article: Dash M, Sahu S, Mohanty I, Narasimham MV,
Turuk J, Sahu R. Prevalence, risk factors and antimicrobial resistance of
asymptomatic bacteriuria among antenatal women. J Basic Clin Reprod Sci
2013;2:92-6.
Source of Support: Nil, Conflict of Interest: None declared
96 Journal of Basic and Clinical Reproductive Sciences · July - December 2013 · Vol 2 · Issue 2