Urinary Tract Infection among Pregnant Women at Pumwani Maternity Hospital, Nairobi, Kenya: Bacterial Etiologic Agents, Antimicrobial Susceptibility Profiles and Associated Risk Factors

Abstract

Urinary Tract Infections (UTIs) during pregnancy are among the most common infections worldwide and can lead to poor perinatal and maternal outcomes. This study determined the prevalence of UTIs during pregnancy, associated risk factors and antimicrobial susceptibility profiles of associated bacterial pathogens. A cross-sectional study was conducted among 210 pregnant women attending antenatal clinic at Pumwani Maternity hospital. Their social-demographic profiles were obtained using a structured questionnaire. Cultures were done from midstream urine and antimicrobial susceptibility testing determined using the disc diffusion test. The overall prevalence of UTI was 15.7% regardless of the women’s age, parity and stage of gestation. Prevalence of asymptomatic and symptomatic bacteriuria was 4.3% and 11.4% respectively. Material of undergarment and frequency of changing the undergarments were found to contribute significantly to the acquisition of UTI (P < 0.05). E. coli was the most predominant UTI organism at (44.5%) followed by K. pneumoniae (21.2%) and S. aureus (15.1%). Almost a half (over 49%) of all Gram-negative organisms showed resistance prevalence against third generation cephalosporins, fluoroquinolones, Sulfamethoxazole-Trimethoprim, Cefoxitin, Nitrofurantoin and Amoxicillin-clavulanic acid. Gram-positive strains were susceptible to Amoxicillin-clavulanic acid, Nitrofurantoin, Linezolid and Ofloxacin. The prevalence of multi-drug resistance (MDR) in all study isolates was 96%. Our data suggest a serious resistance trend among UTI strains and more should be done to slow down this trend. Pregnant women should be screened by urine culture and treatment be guided by the antimicrobial susceptibility data.