Kehinde Aderemi O, Adedapo Kayode S, Aimaikhu Christopher O, Odukogbe Akin-Tunde A, Olayemi Oladapo, Salako Babatunde
Departments of Medical Microbiology and Parasitology, College of Medicine, University of Ibadan, Ibadan, Nigeria.
Trop Med Health. 2011 Sep;39(3):73-6. doi: 10.2149/tmh.2011-02. Epub 2011 Sep 30.
Untreated asymptomatic bacteriuria can lead to urinary tract infection (UTI) in pregnancy with devastating maternal and neonatal effects such as prematurity and low birth weight, higher fetal mortality rates and significant maternal morbidity. We carried out a two year (April 2007 to March 2009) cross-sectional epidemiological study to determine the prevalence of significant bacteriuria among asymptomatic antenatal clinic attendees at two antenatal clinics (ANCs) in University College Hospital and Adeoyo Maternity Hospital, both in Ibadan, Nigeria.All consenting ANC attendees without UTI were enrolled in the study. Urine specimens of 5 to 10 ml collected from each subject were examined microscopically for white blood cells, red blood cells and bacteria. The specimens were further cultured on MacConkey agar using a sterile bacteriological loop that delivered 0.002 ml of urine. Colony counts yielding bacterial growth of more than 10(5)/ml of pure isolates were considered significant.Of the 473 subjects studied, 136 had significant bacteriuria, giving a prevalence rate of 28.8%. The highest age specific prevalence (47.8%) was found in the 25-29 year olds while only one (0.7%) was found in the teenage group. A large percentage (64.0%) of subjects with significant bacteriuria had tertiary education, compared with 4.4% who had no formal education but the association was not statistically significant (X(2) = 0.47, p = 0.79). The majority (75.8%) of subjects with significant bacteriuria had no previous history of abortion, while 20 (14.7%) had one previous abortion and only three (2.1%) admitted to three previous abortions (X(2) = 5.16, p = 0.16). The majority (69.8%) of those with significant bacteriuria presented at second trimester while 38 (28.0%) presented at third trimester (X(2) = 6.5, p = 37).Only 22 (4.6%) of the studied subjects presented at first trimester, and 3 (13.7%) of these had significant bacteriuria.The prevalence of asymptomatic bacteriuria is high among this study population. Hence we suggest that advocacy programs be initiated to urge pregnant women to access ANC services early in pregnancy.
未经治疗的无症状菌尿可导致孕期尿路感染（UTI），对孕产妇和新生儿产生毁灭性影响，如早产、低出生体重、较高的胎儿死亡率以及严重的孕产妇发病率。我们开展了一项为期两年（2007年4月至2009年3月）的横断面流行病学研究，以确定尼日利亚伊巴丹大学学院医院和阿迪奥约妇产医院两家产前诊所中无症状产前检查就诊者中显著菌尿的患病率。所有同意参与的无UTI的产前检查就诊者均纳入研究。从每位受试者收集5至10毫升尿液标本，显微镜检查白细胞、红细胞和细菌。使用接种0.002毫升尿液的无菌细菌接种环将标本进一步接种于麦康凯琼脂培养基上进行培养。菌落计数显示纯分离菌生长超过10(5)/毫升被视为显著菌尿。在473名研究对象中，136名有显著菌尿，患病率为28.8%。年龄特异性患病率最高（47.8%）的是25至29岁年龄组，而青少年组仅1名（0.7%）。有显著菌尿的受试者中很大比例（64.0%）接受过高等教育，相比之下，未接受过正规教育的占4.4%，但该关联无统计学意义（X(2)=0.47，p=0.79）。大多数有显著菌尿的受试者（75.8%）既往无流产史，20名（14.7%）有过一次流产史，仅3名（2.1%）承认有过三次流产史（X(2)=5.16，p=0.16）。大多数有显著菌尿的人（69.8%）在孕中期就诊，38名（28.0%）在孕晚期就诊（X(2)=6.5，p=37）。研究对象中仅22名（4.6%）在孕早期就诊，其中3名（13.7%）有显著菌尿。该研究人群中无症状菌尿的患病率较高。因此，我们建议启动宣传项目，敦促孕妇在孕期尽早接受产前检查服务。
