BACTERIA ASSOCIATED WITH URINARY TRACT INFECTION IN PREGNANT WOMEN AND THEIR ANTIBIOTIC SUSCEPTIBILITY

BACTERIA ASSOCIATED WITH URINARY TRACT INFECTION IN PREGNANT WOMEN AND THEIR ANTIBIOTIC SUSCEPTIBILITY

ABSTRACT
Urine Sample from pregnant women were analyzed for bacteria. The result of urinalysis reveals the appearance –yellow and Cloudy, pH 6.0, protein-ve, Glucose-ve,Blood-ve, Urobilinogen. Normal, Ketone-ve, Nitrate tve, Bilirubin-ve, Ascobic acid –ve in some of the samples. The result of urine microscopy reveal pus cells. 4-6/HPF, Epithelial cell +++, red cells nil, yeast cells nil, crystal nil. Bacterial isolated from the culture include. Staphylococcus aureus, Escheriachia Coli, Klebsiella Spp. The sensitivity test conducted gave the following results. Staphylococcus aureus was sensitive to streptomycin(++), Ciprofloxacin (+++), Amoclox(+) and resistant to cefuroxine. Klebsiella Spp was sensitive to Ciprofloxine (+++) Ofloxacin (++) and resistant to streptomycin, Ampicillin, Ceporex and Nalidixic acid. Eschriachia Coli was sensitive to gentamycin (++), Ofloxacin (+++), Streptomycin (+++) and resistant to Amoxlox and Ampicillin.

CHAPTER ONE
INTRODUCTION
Urinary Tract Infection (UTI) is a common health problem among pregnant women (Saidi et al ,2005). This usually begins in week 6 and peaks during week 22 to 24 of pregnancy due to a number of factors including ureteral dilatation, increased bladder Volume and decreased bladder tone. Along with decreased ureteral tone which contributes to increased urinary stasis and ureterovesical reflux (chaliha et al, 2002). Up to 70% of pregnant women develop glyucosuria, which encouraged bacteria growth in the urine (AI. Issa, 2009). It may manifest as Asympromatic bacteriuria (ASB) or symptomic Bacteriuria (SB). The prevalence of asymptomatic bacteriuria UTI has been previously reported to be 2% to 13% in pregnant women (Delzell et al, 2000). Compared with that of symptomatic Bacteriuria in (UTI) which occur in 1-18% during pregnancy. Urinary tract infection (UTI) during pregnancy may cause complications such as Pyelonephritis, hypertensive disease of pregnancy, anaemia, chronic renal failure premature delivery and foetal mortality.
(Dwyer, et al 2002). The incidence of these complications can be decreased by treating promptly Asymptomatic Bacteriuria (ASB) and Symptomatic (SB) during pregnancy due to the potential adverse sequelea of Urinary tract infection in pregnancy. Most clinic perform routine urinalysis of midstream urine specimen during one or more antenatal clinic (ANC) visits (Smaill 2007). However, culture and antimicrobial drug susceptibility testing are needed for surveillar purposes to guide the clinician on the proper management and prevent empirical treatment of pregnant women with (ASB) and (SB).
A limited spectrum of organisms cause UTI and these include Escherichia Coli, which accounts for the majority of uncomplicated urinary tract infection Isolates. (crupta, et al, 2001). Others are Staphylococcus Saprophyticus, Klebsiella Spp, Proteus Spp, Enterococcus Spp and Enterobacter Spp (Massinde, , et al 2009).
Data on the current distribution and antimicrobial Isolates from pregnant women in Tanania is limited .

Urinary tract infections refer to the presence of microbial pathogen within the urinary tract and it is usually classified by the infection site, bladder (Cystitis), kidney (Pyelonephritis or urine (Bacteria) and also can be a Asymptomatic or symptomatic (UTI) that occur in a normal genitourinary tract with no prior instrumentation are considered as “Uncomplication” whereas “Complicated” Infections are diagnosed in genitourinary tracts that have structural or functional abnormalities Urethral catheters, and are frequently asymptomatic (3,4) (kriptke, 2005).
It has been estimated that globally symptomatic (UTIS) result in as many as 7 millions visits to out patient clinic, 1 million visits to emergency departments, and 100,000 hospitalization annually (5) (chin et al 2011).
Many different microorganisms can cause urinary tract infection (UTIS), though the most common pathogens causing the simple ones in the community are Esherichia Coli and other Enterobacteriacae, which accounts approximately 75% of the isolates (Kebira et al, 2009).
In complicated Urinary tract infections and hospitalized patients, organisms such as Enterococcuss Faecalis and Highly resistant, gram-ve rods including Pseudomoinas Spp. are comparatively more common. The relative frequency of the pathogens varies depending upon age, sex, catheterization and hospitalization.
Urinary tract infection cases is often started empirically an therapy is based on information determined from the antimicrobial resistance pattern of the urinary pathogen. However, a large proportion of uncontrolled antibiotic usage has contributed to the emergency of resistant bacterial Infections (7-10). As a result, the prevalence of antimicrobial resistance among urinary track has been increasing world wide. (Biadglegene. et al, 2009).
Associated resistance i.e, the fact that a bacterium resistant to one antibiotics is often much more likely to be resistant to other antibiotics, drastically decreases the chances of getting a second empirical attempt right. Resistance rates to the most common prescribe drugs used in the treatment of (UTI) vary considerably in different areas, world-wide. The estimation of local etiology and susceptibility profile could support the most effective empirical treatment. Therefore, investigating epidemiology of (UTIS), the prevalence risk factors, are bacterial isolates and antibiotics sensitivity is fundamental for care givers and health planner to guide the expected intervention.

OBJECTIVE OF STUDY
Ø The aim of this study was to determine bacterial etiology agent and evaluate their invitro susceptibility pattern to commonly used antimicrobial agents.
Ø To identify the bacteria Isolates.