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Prevalence of undiagnosed asymptomatic bacteriuria and associated risk factors during pregnancy: a cross-sectional study at two tertiary centres in Cairo, Egypt

Abstract

Background The prevalence of asymptomatic bacteriuria (ASB) during pregnancy is poorly understood in Egypt—a country with a high birth rate.

Objectives To determine the prevalence of ASB among pregnant women booking at El Hussein and Sayed Galal Hospitals in Al-Azhar University in Egypt; and to observe the relationship between ASB prevalence and risk factors such as socioeconomic level and personal hygiene.

Setting Obstetrics and gynaecology clinics of 2 university hospitals in the capital of Egypt. Both hospitals are teaching and referral hospitals receiving referrals from across over the country. They operate specialist antenatal clinics 6 days per week.

Participants A cross-sectional study combining the use of questionnaires and laboratory analysis was conducted in 171 pregnant women with no signs or symptoms of urinary tract infection (1 case was excluded). Samples of clean catch midstream urine were collected and cultured using quantitative urine culture and antibiotic sensitivity tests were performed.

Results Of 171 pregnant women, 1 case was excluded; 17 cases (10%, 95% CI 5.93% to 15.53%) were positive for ASB. There was a statistically significant relation between the direction of washing genitals and sexual activity per week—and ASB. Escherichia coli was the most commonly isolated bacteria followed by Klebsiella. Nitrofurantoin showed 100% sensitivity, while 88% of the isolates were resistant to cephalexin.

Conclusions The prevalence of ASB seen in pregnant women in 2 tertiary hospitals in Egypt was 10%. E. coli and Klebsiella are the common organisms isolated. The direction of washing genitals and sexual activity significantly influences the risk of ASB. Pregnant women should be screened early for ASB during pregnancy; appropriate treatment should be given for positive cases according to antibiotic sensitivity screening. Cephalexin is likely to be of limited use in this management.

  • Asymptomatic Bacteriuria
  • Urinary Tract Infection
  • Urine Culture
  • Egypt

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

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Footnotes

  • MA-AE is the first author.

  • Contributors All authors have participated fully in the conception, writing and critical review of this manuscript. All have seen and agreed to the submission of the final manuscript. MA-AE is the first author, principle investigator, and was involved in design of the work, data collection, sample collection, data analysis and interpretation, writing and drafting the article. AB-V was involved in writing and critical review. MFED is the laboratory physician, and was involved in sample collection and processing, writing, and critical review. FC is the corresponding author, and was involved in writing and critical review.

  • Funding The project was financed by Chinese Government Scholarship ‘Youth of Excellence Scheme Of China (Yes China)’.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Ethics approval El Hussein and Sayed Galal Hospital's Ethical Committee.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Technical appendices of survey questions and additional data are included in the online supplementary material.

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