Asymptomatic Bacteriuria and Anti-Microbial Susceptibility Patterns among Women of Reproductive Age. A Cross-Sectional Study in Primary Care, Ghana

Prince Afoakwa; Seth Agyei Domfeh; Bright Oppong Afranie; Dorcas Ohui Owusu; Sampson Donkor; Kennedy Kormla Sakyi; Richard Akesse Adom; Godfred Kyeremeh; Bright Afranie Okyere; Emmanuel Acheampong; Beatrice Amoah

doi:10.3390/medsci6040118

Asymptomatic Bacteriuria and Anti-Microbial Susceptibility Patterns among Women of Reproductive Age. A Cross-Sectional Study in Primary Care, Ghana

Med Sci (Basel). 2018 Dec 17;6(4):118. doi: 10.3390/medsci6040118.

Affiliations

¹ Department of Medical Laboratory Technology, Faculty of Health and Allied Sciences, Garden City University College, P.O. Box KS 12775, Kenyasi-Kumasi, Ghana. prinyprince2016@gmail.com.
² Department of Medical Laboratory Technology, Faculty of Health and Allied Sciences, Garden City University College, P.O. Box KS 12775, Kenyasi-Kumasi, Ghana. sadomfeh@gmail.com.
³ Department of Molecular Medicine, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, PMB, UPO, Kumasi, Ghana. afranieoppongbright@gmail.com.
⁴ Department of Medical Laboratory Technology, Faculty of Health and Allied Sciences, Garden City University College, P.O. Box KS 12775, Kenyasi-Kumasi, Ghana. dorcso.owusu@gnail.com.
⁵ Department of Molecular Medicine, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, PMB, UPO, Kumasi, Ghana. sampsondonkor08@gmail.com.
⁶ Department of Microbiology, Tetteh Quarshie memorial hospital, Akuapem Mampong-Korforidua, P.O. Box 26, Ghana. kenritason99@yahoo.com.
⁷ Department of Microbiology, Tetteh Quarshie memorial hospital, Akuapem Mampong-Korforidua, P.O. Box 26, Ghana. akwasioppon977@gmail.com.
⁸ Department of Medical Laboratory Technology, Faculty of Health and Allied Sciences, Garden City University College, P.O. Box KS 12775, Kenyasi-Kumasi, Ghana. godfreddii@gmail.com.
⁹ Department of Theoretical and Applied Biology, Faculty of Biosciences, Kwame Nkrumah University of Science and Technology, PMB, UPO, Kumasi, Ghana. richardasareafranie@gmail.com.
¹⁰ Department of Molecular Medicine, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, PMB, UPO, Kumasi, Ghana. emmanuelachea1990@yahoo.com.
¹¹ Department of Molecular Medicine, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, PMB, UPO, Kumasi, Ghana. abeatrice111@gmail.com.

Abstract

Background: Asymptomatic bacteriuria (ASB) poses serious future clinical repercussions for reproductive women. The study determined the prevalence of asymptomatic bacteriuria along with anti-microbial susceptibility patterns among women of reproductive age in a primary care facility. Method: The study recruited a total of 300 women of reproductive age attending the Tetteh Quarshie Memorial Hospital at Akuapem-Mampong, Ghana, between January and March 2018. Questionnaires were administered to obtain demographic data and predisposing risk factors of ASB. An early-morning midstream urine sample was collected from participants. Urinalysis, urine culture, and anti-microbial susceptibility testing were performed. Results: The mean age of participants was 25.43 years. The overall prevalence rate of ASB was 40.3%. The prevalence was higher among pregnant women compared to non-pregnant women (33.3% vs 7.0%). The most common bacterial isolate was E. coli (47.0%) followed by Proteus spp. (36.4%), Klebsiella spp. (8.3%), and E. faecalis (8.3%). Leukocyturia (35.0%) followed by nitrate (30.0%) were the most common urine abnormalities identified on dipstick urinalysis. Most bacteria isolates showed increased resistance to ampicillin (95.04%) and tetracycline (95.04%) while most of the bacterial isolates were sensitive to levofloxacin (94.35%). Demographic characteristics including age (p < 0.001), educational level (p < 0.001), residency (p = 0.001), and marital status (p = 0.005) were significantly associated with ASB. Lifestyle characteristics such as sexual status (p = 0.001) and frequency of washing of intimate parts after sexual intercourse (p < 0.001) were also significantly associated with ASB. Conclusion: Asymptomatic bacteriuria, particularly E. coli and Proteus spp. are prevalent in the urine of pregnant women living in Akuapem-Mampong municipality. Hence public education along with early screening of ASB is essential to reducing future risk of reproductive health complications. Future studies are required to assess the impact of public health on the rate of bacterial infections.

Keywords: bacteria; culture; urinalysis; urinary tract infections.