Urinary Tract Infection in Pregnant Women and Antibiotic Susceptibility Pattern of Bacterial Isolates with Reference to Extended Spectrum Beta Lactamase Producing Strains

Abstract

The objective of this study was to determine the prevalence of urinary tract infection among the pregnant women and antibiotic susceptibility pattern of bacterial isolates with reference to extended spectrum β-lactamase producing strains. This cross sectional study was conducted at Paropakar Maternity and Women’s Hospital,Thapathali, Kathmandu from June to December 2010 among 1720 pregnant women attending their antenatal checkup. Information regarding various characteristics was obtained and urinespecimen was processed for isolation of bacteria, performing antibiotic susceptibility test byKirby-bauer disc diffusion method and ESBL test by Double Disc Synergy Test (DDST) method. The prevalence of UTI was found to be 30.5%. Majority of the pregnant women were fromoutpatient department of hospital (65.7%), urban areas of the country (52.3%), age group 21-30years (74.3%), unemployed (73.3%), literate (88.0%), primiparous (54.3%) and second trimesterof pregnancy (48.3%). Parity, education status, occupation of pregnant women, times of bathing,history of UTI, presence of pus cells and RBC in urine was found to be the risk factors of UTIfrom both univariate and multivariate analysis. E. coli (52.0%) was found to be the mostpredominant isolate and Pseudomonas aeruginosa (0.7%) was least one. Gentamicin andamikacin were found to be the most effective antibiotics. About 72.0% of the isolates were foundto be multidrug resistant with higher rate in hospitalized patients (84.0%). About 20.0% ofE.coli and 36.4% of the Klebsiella pneumoniae were found to be the ESBL producers. There is a great need to follow strictly the hospital antimicrobial policy in order to prevent the emergence and dissemination of MDR and ESBL producing microorganisms as they are associated with the treatment failure of UTI. KEY WORDS: Pregnant women, UTI, multi drug resistant, ESBL