Sujatha R, Nawani Manju
Associate Professor, Department of Microbiology, Rama Medical College Hospital and Research Centre , Kanpur, India .
Professor and H.O.D, Department of Obstretics and Gynaecology, Rama Medical College Hospital and Research Centre , Kanpur, India .
J Clin Diagn Res. 2014 Apr;8(4):DC01-3. doi: 10.7860/JCDR/2014/6599.4205. Epub 2014 Apr 15.
Symptomatic and asymptomatic bacteriuria (ASB) is common in pregnant women. Pregnancy enhances the progression from ASB to symptomatic bacteriuria, which if left untreated, could lead to acute pyelonephritis and other adverse outcomes such as prematurity, postpartum, hypertensive disease, anaemia, UTIs and higher foetal mortality rates.
To identify the prevalence of ASB, the most common causative microorganisms and the antibacterial susceptibilities of the isolated microorganisms at a tertiary care centre at Kanpur, India.
A total number of 300 asymptomatic pregnant women were screened for ASB by urine culture by using a semi quantitative culture method.
In this study, significant bacteriuria was found in only 22 cases (7.3%). Growth of contaminants was seen in 40 cases (13.3%). Among cases which showed positive cultures, 48.9% were primigravidae and 51.1% were multigravidae. Highest incidence was reported in age group of 21-30 years. The predominant organisms which were isolated were Escherichia coli, followed by Klebsiella pneumoniae, Enterococcus faecalis, Staphylococcus aureus and Proteus mirabilis. Escherichia coli, the most common isolate, was found to be only 61% and 70% sensitive to ampicillin and amoxicillin + clavulanate, respectively. Sensitivity to ceftriaxone and ciprofloxacin was 95%, and sensitivity to amikacin was 99%. Hundred percent sensitivity was found for the broad spectrum pencillins, imipenem, and meropenem. Klebsiella pneumoniae, the second most frequent organism which was grown on culture, was only 11% sensitive to ampicillin, while sensitivity to amoxicillin + clavulanate and cefuroxime was 86%. 100% sensitivity was found for cefepime, ceftriaxone, ciprofloxacin, imipenem and meropenem.
Routine urine culture test should be carried out for all antenatal women, to detect asymptomatic bacteriuria, and every positive case should be treated with appropriate antibiotic therapy, to prevent any obstetric complication which is associated with pregnancy.
有症状和无症状菌尿症（ASB）在孕妇中很常见。怀孕会促使无症状菌尿症发展为有症状菌尿症，若不进行治疗，可能会导致急性肾盂肾炎以及其他不良后果，如早产、产后高血压疾病、贫血、尿路感染和较高的胎儿死亡率。
确定印度坎普尔一家三级护理中心无症状菌尿症的患病率、最常见的致病微生物以及分离出的微生物的抗菌敏感性。
采用半定量培养法通过尿培养对300名无症状孕妇进行无症状菌尿症筛查。
在本研究中，仅22例（7.3%）发现显著菌尿。40例（13.3%）出现污染物生长。在培养呈阳性的病例中，初产妇占48.9%，经产妇占51.1%。21 - 30岁年龄组报告的发病率最高。分离出的主要微生物是大肠埃希菌，其次是肺炎克雷伯菌、粪肠球菌、金黄色葡萄球菌和奇异变形杆菌。最常见的分离菌大肠埃希菌对氨苄西林和阿莫西林 + 克拉维酸的敏感性分别仅为61%和70%。对头孢曲松和环丙沙星的敏感性为95%，对阿米卡星的敏感性为99%。对广谱青霉素、亚胺培南和美罗培南的敏感性为100%。培养出的第二常见微生物肺炎克雷伯菌对氨苄西林的敏感性仅为11%，而对阿莫西林 + 克拉维酸和头孢呋辛的敏感性为86%。对头孢吡肟、头孢曲松、环丙沙星、亚胺培南和美罗培南的敏感性为100%。
应对所有产前妇女进行常规尿培养检查，以检测无症状菌尿症，每例阳性病例均应接受适当的抗生素治疗，以预防与妊娠相关的任何产科并发症。
