Laboratory aspects of asymptomatic bacteriuria in pregnancy

Marlyn Mohammad, Zaleha Abdullah Mahdy, Jamil Omar, Noorashikin Maan, M. A. Jamil

Research output: Contribution to journalArticle

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Abstract

A total of 1,661 pregnant women aged between 13 and 45 years were screened for bacteriuria by urine culture. Of the 1,661 culture results. 615 (37%) yielded no growth; 728 (43.8%) yielded no significant growth (presence of <105 organisms/ml urine of one or more types of bacteria); 286 (17.2%) yielded mixed growth (presence of >105 organisms/ml urine of more than one type of bacteria) and only 32 (1.9%) showed significant growth (presence of >105 organisms/ml urine of a single bacterium). Urine microscopy was also conducted. Two hundred and twenty-four (13.5%) specimens had > 10 white blood cells/ml urine, of which 66 had > 100 white blood cells; 13 were from the significant growth group. Three hundred and seventy-four (22.5%) specimens showed the presence of bacteria, 42 (2.5%) had red blood cells, 370 (22.3%) had epithelial cells, 58 (3.5%) had crystals, and 14 (0.8%) had yeasts. The most common bacterium isolated was Escherichia coli (12; 40%); the others included group B Streptococcus (5; 15%), Klebsiella spp (5; 15%), Diphtheroids (2), and Candida albicans (2). Fifty-two percent of tested strains were sensitive to ampicillin; 24 of 28 strains (85.7%) were sensitive to ciprofloxacin; all 7 strains tested were sensitive to nitrofurantoin and all 20 strains tested were sensitive to cotrimoxazole; 14/20 (70%) and 16/17 (94.1%) were sensitive to cephalexin and cefuroxime respectively. This study shows that asymptomatic bacteriuria does occur in pregnant women, albeit at a very low rate in an urban setting like Cheras. Urine microscopy is not specific and only serves as a guide to bacteriuria. The commonest causative organisms are those from the gastrointestinal tract and vagina. The antibiogram showed that cefuroxime and cephalexin are likely to be effective in treating bacteriuria : ampicillin must be reserved for Gram-negative organisms. For Gram-positive organisms, of which Group B Streptococcus is important, ampicillin is still effective in vitro. Nitrofurantion and cotrimoxazole have excellent activity in vitro and should be considered for therapy. 17.2% of the urine culture yielded mixed growth: likely to indicate that contamination of urine specimens still happens despite the strict instructions given to patients about the collection of a midstream urine specimen. Proper collection, appropriate transport, and the early processing of urine specimens remain essential.

Original languageEnglish
Pages (from-to)575-580
Number of pages6
JournalSoutheast Asian Journal of Tropical Medicine and Public Health
Volume33
Issue number3
Publication statusPublished - 2002

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Bacteriuria
Urine
Pregnancy
Ampicillin
Bacteria
Cephalexin
Growth
Cefuroxime
Streptococcus agalactiae
Sulfamethoxazole Drug Combination Trimethoprim
Pregnant Women
Microscopy
Leukocytes
Nitrofurantoin
Klebsiella
Microbial Sensitivity Tests
Vagina
Ciprofloxacin
Candida albicans
Gastrointestinal Tract

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Laboratory aspects of asymptomatic bacteriuria in pregnancy. / Mohammad, Marlyn; Abdullah Mahdy, Zaleha; Omar, Jamil; Maan, Noorashikin; Jamil, M. A.

In: Southeast Asian Journal of Tropical Medicine and Public Health, Vol. 33, No. 3, 2002, p. 575-580.

Research output: Contribution to journalArticle

Mohammad, Marlyn ; Abdullah Mahdy, Zaleha ; Omar, Jamil ; Maan, Noorashikin ; Jamil, M. A. / Laboratory aspects of asymptomatic bacteriuria in pregnancy. In: Southeast Asian Journal of Tropical Medicine and Public Health. 2002 ; Vol. 33, No. 3. pp. 575-580.
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