ASYMPTOMATIC BACTERIURIA IN ANTENATAL PATIENTS.

Introduction: Urinary tract infections (UTI) affects all ages, but women are more susceptible. UTI is a common problem in pregnancy due to various morphological and physiological changes that takes place in the genitourinary tract during pregnant state. Asymptomatic bacteriuria (ASB) refers to a condition in which urine culture reveals a significant growth of pathogens that is >105 bacteria/hpf, but without the presence of symptoms of UTI. Asymptomatic bacteriuria is found in 2-10% of pregnant women and pregnancy enhances the progression from asymptomatic to symptomatic bacteriuria which can lead to adverse maternal and foetal outcome. Objectives: To assess the incidence of asymptomatic bacteriuria in antenatal patients and to identify the common pathogens responsible for the same. Material& Methods: A total of 200 consecutive OPD/ IPD ANC patients, registered at a tertiary care centre, were taken for study after taking informed consent.Detailed history, general examination and obstetric examination along with routine ANC check-up was done for all patients. Mid-stream urine sample was collected from all patients at 16-20wks, 28-32wks and at 36wks. This sample is subjected to microscopic evaluation, urine culture and sensitivity and colony count. In case of positive report, women were treated as per the culture sensitivity report. All the positive subjects were re-evaluated for existence of asymptomatic bacteriuria. All the reports were recorded in a pre-designed proforma. Data was analyzed using statistical software SPSS ver. 21. Results: ASB was observed in 7.5%subjects at 16-20weeks, 14% at 28-32 weeks and 8.5% subjects at 36 weeks with overall prevalence of 19% during pregnancy.Most common organism isolated was Escherichia coli (62%) followed by Klebsiella (20%) and Staph. Aureus (8%). A significant association was observed between ASB and maternal and foetal complications like pre-term delivery, anemia and low birth weight (p<0.05). Conclusion: About one fifth of the pregnant females suffer from asymptomatic bacteriuria during pregnancy. Pregnant women with ASB are at increased risk for adverse maternal and fetal outcomes like anemia, pre-term delivery and low birth weight. We thus recommendthat routine screening and treatment of ASB should be carried out on all antenatal patients in order to identify any unsuspecting infection.