Prevalence of Multi Drug Resistance Escherichia coli Bacteriuria among Antenatal Women in a Tertiary Hospital in Enugu, Nigeria

Background: Urinary Tract Infection (UTI) due to Escherichia coli (E. coli) is a common health problem among women. Pregnant women are at increased risk due to the physiological changes associated with pregnancy. The present study was designed to determine the prevalence of E. coli UTI and its antibiotic susceptibility pattern among pregnant women at the antenatal clinic of the Enugu State University of Science and Technology Teaching Hospital, Enugu, Nigeria.

Materials and Methods: A cross sectional study was carried out on a total of 200 pregnant women with and without symptoms of UTI. Mid-stream urine samples were collected and inoculated into Cysteine Lactose Electrolyte Deficient (CLED) and MacConkay. Colony counts > 102 cfu/ml of urine were regarded as significant bacteriuria. Pure isolates of bacterial pathogen were characterized by colony morphology, gram-stain and standard biochemical procedures. The method of agar disc diffusion susceptibility testing was used to determine the antibiotic resistance and sensitivity of the isolates.

Results: The overall prevalence of UTI was 15.4% while 48.5% were symptomatic cases and 5.0% asymptomatic cases. E,Coli was the most frequently isolated organism with a prevalence of 53.4% (111 samples) while other pathogens accounted for 46.6% (89 samples). E. coli showed the highest resistance to the antibiotic Ampicillin 100%, 78% to Tetracycline and 70% to Rocephine but a low resistance of 16.7% against Nitrofurantoin and Ceftriazone respectively.

Conclusion: UTI due to E. coli in pregnant women in Enugu is relatively high and shows high resistance to routine antibiotics. It is therefore, strongly recommended to undertake a routine culture as part of the antenatal care for pregnant women.