INCIDENCE OF ASYMPTOMATIC BACTERIURIA AMONG PREGNANT WOMEN IN SABON-GARI LGA – ZARIA, NIGERIA AND THE ANTIMICROBIAL SUSCEPTIBILITIES OF THE ISOLATES

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2013-03
Authors
BOLAJI, Rebecca Olajumoke
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Abstract
Urinary tract infection (UTI) occurs frequently in pregnancy with a large number of infections being asymptomatic. This study was therefore conceived to determine the incidence of asymptomatic bacteriuria in pregnant women in Sabon- Gari LGA – Zaria, Nigeria using questionnaire as well as isolate and characterize any bacteria present in urine of apparently healthy pregnant women and to determine the antibiogram of such isolates. Urine samples from two hundred and fifty (250) apparently healthy pregnant women, who were attending ante-natal clinics in Sabon-Gari Local Government Area Zaria, Nigeria, were interviewed and urine samples were collected for isolation of any possible bacteria present. Isolation was done by culturing on standard laboratory media and identification of isolates were subsequently done using standard biochemical tests and confirmed using API (bioMerieux, USA) rapid kits. The antibiogram of the isolates were determined using selected antibiotics and using disc agar diffusion technique. Plasmid isolation using gel electrophoresis was carried out on selected isolates that were multiple antibiotics resistant. Molecular characterization using multiplex Polymerase Chain Reaction (PCR) was carried out to detect nature of resistance in the resistant isolates. Primers such as SHV, OXA, TEM, aaclla, gyrA and gyrB, that codes for resistant genes for aminoglycosides, penicillins, cephalosporins and fluoroquinolones were used. Tests were also carried out to detect the production of β-lactamase and extended spectrum β-lactamase enzymes in the resistant isolates. A total of 146 (58.4%) had levels of bacteria indicative of asymptomatic bacteriuria. Higher incidences were found among 21-30 years age group 92 (36.8%), those in their second trimester 77 (30.8%) and among third parity (number of pregnancy) patients. Standard biochemical tests revealed the presence of 197 isolates comprising of Staphylococcus spp 50 (20.0%), Klebsiella spp 49 (19.6%), Proteus spp 46 (18.4%), Escherichia spp 33 (13.2%), Pseudomonas spp 18 (7.2%) and Streptococcus spp 1 (0.4%). Using API Staph kits a total of 20 Staphylococcus species made up of Staph. aureus, Staph. lentus, Staph. xylosus, Staph. cohnii, Staph. auriculous, Staph. epidermidis, Staph. heamolyticus and Micrococcus spp 4(10.3%) were identified. The API 20E kit revealed the presence of 22 Enterobacteriaceae made up of Escherichia coli, Enterobacter cloacae, Citrobacter freundii, Citrobacter braakii, Providencia rettgreri, Klebsiella pneumonia while API 20NE kit revealed the presence of Pseudomonas aeruginosa, Aeromonas aerohydrophila/caviae, Pseudomonas leutola, Burkholderia pseudomallei. The susceptibility profile of the isolates to selected antibiotics shows that all the isolates were resistant to the β-lactam antibiotics (Ampicillin (AMP) and Methicillin (MET) but relatively sensitive to Ofloxacin (87.5%), Gentamicin (71.4%), Nitrofurantoin (69.4%), and Ciprofloxacin (87.0%). A large number of the isolates were multiple antibiotics resistant. Some of the isolates were β-lactamase and Extended Spectrum β-lactamases (ESBLs) producers. Molecular characterization of the plasmid DNA showed the presence of resistant gene determinants that code for resistance to ESBLs.
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A DISSERTATION SUBMITTED TO THE POSTGRADUATE SCHOOL, AHMADU BELLO UNIVERSITY, ZARIA-NIGERIA IN PARTIAL FULFILLMENT FOR THE AWARD OF DOCTOR OF PHILOSOPHY IN PHARMACEUTICAL MICROBIOLOGY DEPARTMENT OF PHARMACEUTICS AND PHARMACEUTICAL MICROBIOLOGY, AHMADU BELLO UNIVERSITY, ZARIA MARCH, 2013
Keywords
INCIDENCE,, ASYMPTOMATIC,, BACTERIURIA,, AMONG,, PREGNANT,, WOMEN,, SABON-GARI LGA,, ZARIA,, NIGERIA, ANTIMICROBIAL,, SUSCEPTIBILITIES,, ISOLATES
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