Indian Journal of Obstetrics and Gynecology Research

Print ISSN: 2394-2746

Online ISSN: 2394-2754

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Indian Journal of Obstetrics and Gynecology Research (IJOGR) open access, peer-reviewed quarterly journal publishing since 2014 and is published under auspices of the Innovative Education and Scientific Research Foundation (IESRF), aim to uplift researchers, scholars, academicians, and professionals in all academic and scientific disciplines. IESRF is dedicated to the transfer of technology and research by publishing scientific journals, research content, providing professional’s membership, and conducting conferences, seminars, and award more...

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Get Permission Hajira, Imrana, and Kamparj: Evaluation of antibacterial susceptibility profile in pregnant women with asymptomatic bacteriuria in Kadapa


Introduction

Urinary tract infection (UTI) is the foremost prevailing bacterial infection during pregnancy. The urinary tract infection in pregnancy may be symptomatic (cystitis, pyelonephritis) or asymptomatic (bacteriuria without symptoms). Based on the research evidence available, the prevalence of symptomatic and asymptomatic urinary tract infections in pregnant women has been 17.9% and 13% respectively.1, 2 The urethra's small length, lack of prostatic secretions, pregnancy, and the probability of urinary tract contamination by faecal bacteria make women more prone to UTIs than men.3 Asymptomatic bacteriuria can lead to maternal and neonatal complication like preterm labour, pre-eclamptia, IUGR, Preterm babies.4, 5 Enterobacteriaceae, which are frequently present in the gastrointestinal system, are the source of most infections; 80–90% of these instances are caused by Escherichia coli, or E. coli. Other bacteria, such as coagulase-negative Staphylococcus, Klebsiella pneumoniae, Group-B Streptococcus saprophyticus, Proteus mirabilis and, Staphylococcus aureus, are present in smaller amounts.6

The empirical antimicrobial therapy commenced prior to the laboratory antibiotic sensitivity tests outcomes of urine culture, may leads to increase in resistant among uropathogens.7 The prevalence of resistance among UTI patients is rising and varies according on the patient's geographic & regional area.8 Treatment recommendations are often determined by taking into account frequently occurring infections, susceptibility patterns, evidence, physician acceptance, antimicrobial stewardship norms, availability of formularies, and antimicrobial prices.

Choosing the appropriate antibiotic for each patient while considering the safety profile of both the mother and the newborn is crucial, and treatment recommendations for UTIs have been produced globally to help clinicians in this regard. The regular screening of antibacterial susceptibility of available therapeutic agents may help to prevent antibacterial resistance and, to furnish revised antibacterial guidelines for the rationale approach to UTI in pregnancy. So the study was conducted.

Materials and Methods

Cross-sectional study was conducted at antenatal care (ANC) in Fathima Institute of Medical Sciences Kadapa, from December 2022 to December 2023. Being pregnant and having an ANC follow up were involved in the study. The study excluded pregnant women who had taken antibiotics within the two weeks prior to their ANC follow-up and symptomatic UTI pregnant women. Competent nurses collected clinical and sociodemographic data using a structured questionnaire. A sterile container with a wide opening was used to collect 10 ml of clean catch midstream urine samples from every study participant. The urine sample that was obtained was labeled and transported to the hospital laboratory less than one to one and half hour.9 By calibrated wire loops (0.001 ml), urine samples were plated on blood agar, MacConkey, and Cystine Lactose Electrolyte-Deficient (CLED) media. After that, all plates were aerobically incubated at 37°C for 24 hours. The bacterial growth in all plates was examined under microscope and, if the count of colonies is more than 105 CFU, and is deemed to be a significant growth.

The species level identification was done by employing the conventional microbiological procedures, colony features, Gram-staining response, and pattern of biochemical profiles to all significant positive cultures. The KIA agar method, H2S generation, carbohydrate fermentation, urease test, indole production, motility test, citrate consumption and, oxidase test were used to identify the enterobacteriaceae. Catalase and coagulase tests were employed to identify the Gram positive bacteria. A tube with 4-5 mL of nutrient broth was filled with three to five pure colonies, gently mixed, and cultured for two to six hours at 35–37 °C. To standardize the size of the inoculum, the suspension's turbidity was evaluated using McFarland 0.5 tubes.7 Inoculate the whole Mueller-Hinton agar (MHA) (Oxide Ltd, Hampshire, UK) surface equally by dipping a sterile cotton swab into the solution. The inoculated plates were left at room temperature to dry for 3–15 min.6, 10 Following the organism inoculation and disc implantation, plates were incubated for twenty-four hours. The inhibitory zones were evaluated 24 hours later.

The antibiotics that were assessed in this study were: Nitrofurantoin (300 μg), Azithromycin (15 μg), Gentamicin (10 μg), Ciprofloxacin (5 μg), Norfloxacin (10 μg), Trimethoprim-Sulphamethoxazole (co-trimoxazole) (1.25-23.75μg), Ceftriaxone (30 μg) and Amoxycillin (10 μg), Amoxycillin-Clavulinic Acid, Tetracycline (30 μg), Meropenem (10 μg). In accordance with the Clinical Laboratory Standards Institute (CLSI) the data were evaluated.11 Before every patient's samples were collected, informed consent was sought both verbally and in writing. The research was initiated with the necessary institutional ethics committee permission. The American Type Culture Collection (ATCC) 25922, Staphylococcus aureus (ATCC 25923), Enterococcus fecalis (ATCC 29212), and, Pseudomonas aeruginosa (ATCC 27853) were utilized as standard strains for quality control. The antibiotic discs, quality control stains and, culture media were attained from HiMedia Laboratories, Mumbai, India.

Statistical analysis

The survey data reviewed carefully, coded and imported into excel. The data was exported to SPSS version 25 for descriptive statistics.

Results

According to the sampling technique described in the methodology, 377 pregnant women participated in the present study. Among them 243 urban participants and 134 rural participants from Kadapa district. Out of the participants, 86, 151 and, 140 participants were <25 years, 25-30 and, >30 years old respectively. Among study participants, 73 were illiterates, 99 had primary education, 158 had secondary education, and 47 had higher education. According to family income, the participants were poor (76), middle class (110), upper middle class (168), and rich.12 Out all study participants, 96 were housewives, 125 were businesswomen, 151 were working professionals and 5 participants were students (Table 1).

Table 1

Sociodemographic characteristics of pregnant women

Variable

Frequency

Percentage

Age

< 25

86

23

26-30

151

40

>31

140

37

 Total

377

100

Residence

urban

243

64

Rural

134

36

 Total

377

100

Educational Status

Illiterate

73

19

Primary Education

99

26

Secondary Education

158

42

Higher Education

47

12

 Total

377

100

Family Income

Poor

76

20

Middle Class

110

29

Upper middle class

168

45

Rich

23

6

 Total

377

100

Occupational Status

Housewife

96

25

Businesswomen

125

33

Employee

151

40

Student

5

1

 Total

377

100

The frequency and percentage analysis was done by SPSS software

Table 2

Clinical characteristics of study participant

Variable

Frequency

Percentage

Gestational period

1st trimester

92

24

2nd trimester

176

47

3rd trimester

109

29

 Total

377

100

Gravida

Primigravida

86

23

Multigravida

291

77

377

100

History of Catheterization

No

362

96

Yes

15

4

377

100

History of Diabetes Mellitus (DM)

No

367

97

Yes

10

3

377

100

History of Abortion

No

354

94

Yes

23

6

377

100

History of Obst. & Gynec surgery

No

360

95

Yes

17

5

377

100

History of premature labor

No

372

99

YES

5

1

377

100

History of previous UTI

No

320

85

Yes

57

15

377

100

The frequency and percentage analysis was done by SPSS software

According to Table 2, second trimester (176), multigravida (291) participants were in majority number. Few participants recruited with history of Catheterization, diabetes mellitus, abortion, obstetric and gynecologic surgery, premature labor, previous UTI.

Table 3

Prevalence of uropathogen in pregnant women

Micro organism

Frequency

Percent

Gram Negative Organism

79

77

Escherichia coli

36

34.95

Klebsiella spp.

26

25.24

Citrobacter spp.

7

6.80

Pseudomonas spp.

6

5.83

Proteus spp.

1

0.97

Enterobactor spp.

3

2.91

Gram Positive Organism.

24

23

Enterococcus spp.

6

7.77

Coagulase Negative Staphylococci (CONS)

12

11.65

Staphylococcus Aures

6

3.88

103

100.00

The frequency and percentage analysis was done by SPSS software

The uropathogens isolated from the urine samples of the participants were tabulated and represented in the Table 3. In the current research 77 percentage (79) of microorganism isolates were gram negative and 23 (24) percentage was Gram positive among 103 microorganism isolates. Out of seventy-nine isolates 36, 26, 7, 6, 1 and, 3 were Escherichia coli, Klebsiella spp., Citrobacter spp., Pseudomonas spp., Proteus spp., and Enterobactor spp respectively. Out of 24 gram positive isolates 6, 12, and 6 isolates were enterococcus, Coagulase Negative Staphylococci (CONS), and Staphylococcus aures.

Table 4

Antibacterial susceptibility configuration of isolated uropathogens in the study

Microorganism

Pattern

Nitrofuran- toin (300 μg)

Azithromycin (15 μg)

Gentamicin (10 μg)

Ciprofloxacin (5 μg)

Norfloxacin (10 μg)

(Co- trim) (1.25 23.75μg)

Ceftriaxone (30 μg)

Amoxycillin (10 μg)

Amoxycillin-Clavulinic Acid

Tetracycline (30 μg)

Meropenem (10 μg)

Gram Negative Organism

Escherichia coli (36)

S

31

27

26

24

27

28

29

3

15

7

33

I

1

3

4

3

2

3

2

1

3

1

2

R

4

6

6

9

7

5

5

32

18

28

1

Total

36

36

36

36

36

36

36

36

36

36

36

Klebsiella spp (26)

S

16

21

19

17

20

22

19

2

10

8

20

I

1

1

0

1

2

2

2

3

4

14

2

R

9

4

7

8

4

2

5

21

12

4

4

Total

26

26

26

26

26

26

26

26

26

26

26

Citrobacter spp. (7)

S

7

5

5

4

5

5

5

0

1

3

6

I

1

1

0

1

0

1

1

1

2

0

0

R

0

1

2

2

2

1

1

6

4

4

1

Total

8

7

7

7

7

7

7

7

7

7

7

Pseudomonas spp. (6)

S

4

3

4

4

4

5

5

0

2

0

5

I

1

1

1

1

0

0

1

0

1

1

1

R

1

2

1

1

2

1

0

6

3

5

0

6

6

6

6

6

6

6

6

6

6

6

Proteus Spp. (1)

S

0

1

1

0

1

1

1

0

0

0

1

I

1

0

0

1

0

0

0

0

1

0

0

R

0

0

0

0

0

0

0

1

0

1

0

Total

1

1

1

1

1

1

1

1

1

1

1

Enterobactor Spp. (3)

S

2

2

1

1

2

2

1

0

1

0

1

I

0

1

1

1

0

1

1

1

0

1

0

R

1

0

1

1

1

0

1

2

0

0

0

Total

3

3

3

3

3

3

3

3

1

1

1

Gram Positive Organism

Enterococcus Spp (6)

S

4

4

4

3

4

5

5

0

2

1

5

I

0

0

1

1

0

1

0

1

1

2

0

R

2

2

1

2

2

0

1

5

3

3

1

Total

6

6

6

6

6

6

6

6

6

6

6

Coagulase Negitive Staphylococci (CONS) (12)

S

10

9

8

7

8

9

9

1

5

1

9

I

1

2

1

2

2

2

1

1

1

2

2

R

1

1

3

3

2

1

2

10

6

9

1

Total

12

12

12

12

12

12

12

12

12

12

12

Staphylococcus Aures (6)

S

4

3

4

3

4

5

4

0

2

0

5

I

1

1

1

1

2

1

1

1

1

2

0

R

1

2

1

2

0

0

1

5

3

4

1

Total

6

6

6

6

6

6

6

6

6

6

6

[i] The number of strains that were sensitive was displayed in the table. S- Sensitive strains, I – Intermediate Strains, R- Resistance strains

The antibacterial sensitive of 6 gram negative and 3 gram positive organisms were depicted in relation with Nitrofurantoin (300 μg), Azithromycin (15 μg) Gentamicin (10 μg)   Ciprofloxacin (5 μg)   Norfloxacin (10 μg)  (co-trim) (1.25 23.75μg) Ceftriaxone (30 μg)  Amoxycillin (10 μg) Amoxycillin-Clavulinic Acid   Tetracycline (30 μg)   Meropenem (10 μg) and the same was tabulated in Table 4.

The major uropathogenic bacteria in the present study were Escherichia coli (36), Klebsiella spp (26) and Coagulase Negitive Staphylococci (CONS) (12) belongs to gram negative and positive bacteria respectively.

Escherichia coli

The evaluated antibacterial sensitivity of Escherichia coli was grater with, Meropenem (10 μg), Nitrofurantoin (300 μg), Ceftriaxone (30 μg), co-trimoxazole (1.25 - 23.75μg), Norfloxacin (10 μg), Azithromycin (15 μg) Gentamicin (10 μg), Ciprofloxacin (5 μg). E coli showed resistance to Amoxycillin (10 μg),   Tetracycline (30 μg) and the antibacterial sensitivity was moderate to Amoxycillin-Clavulinic Acid.

Klebsiella species

The strains in the Klebsiella species of this study were sensitive to co-trimoxazole (1.25 23.75μg), Azithromycin (15 μg), Norfloxacin (10 μg), Meropenem (10 μg), Ceftriaxone (30 μg), Gentamicin (10 μg), Ciprofloxacin (5 μg), Nitrofurantoin (300 μg). Klebsiella spices demonstrated intermediate antibacterial sensitivity to Amoxycillin-Clavulinic Acid, and were highly resistant to Tetracycline (30 μg), Amoxycillin (10 μg).

Coagulase Negative Staphylococci (CONS)

Coagulase Negative Staphylococci (CONS) is a major gram positive bacterium observed in the present study was sensitive to Nitrofurantoin (300 μg), Azithromycin (15 μg), co-trimoxazole, Ceftriaxone (30 μg), Meropenem (10 μg), Gentamicin (10 μg), Norfloxacin (10 μg), Ciprofloxacin (5 μg) and resistant to Amoxycillin (10 μg), Tetracycline (30 μg), Amoxycillin-Clavulinic Acid.

Discussion

The proper diagnosis and treatment are preferred to impede the risk of morbidity and fatal conditions due to uropathogens in pregnancy. There are better antibiotics available for treatment of UTIs in pregnancy, majority of them included in category B of the US-FDA guidelines sense that they have negligible evidences of untoward effects, some in category C have to be cautious in their usage.13 The availability of better antibiotics for UTI is always in the front line to discuss due to the resistance developed by the uropathogens. The prevalence of UTI and susceptibility of its causative agents vary with geographical distribution.14 In this context, resistance is an issue that is steadily becoming worse around the globe and has intriguing patterns.15 Irrational and prior usages of antibiotics are great risk factors. Resistance, irrational, miss use were driving forces to conduct the study in Kadapa region of Andhra Pradesh, India.

The current study results demonstrated that participants lived in urban area (64%) was affected. The results also suggest that 42% of participants who had secondary educations as highest level of education, 45% of participants belong to upper middle-class family and, 40% of working professionals in the study were affected. Due to limited participants, the association of obstetrics-clinical features such as diabetes mellitus, history of catheterization, obstetric and gynecologic surgery, abortion, premature labor, previous UTI was observed in fewer participants.

This study was supported by Matalka et al a retrospective study stated that E. coli and CoNS were the utmost acknowledged bacteria. The significant increase in antibacterial resistance in Enterobacter species was established.16 This pattern of isolates was supported by de Souza et al systematic review by includig 67 studies. Their review results suggested that major isolate bacterial species were Escherichia coli, Klebsiella spp. Staphylococcus sp., excluding Staphylococcus aureus, Proteus mirabilis and Enterobacter spp.17, 18

The Gram-staining response, colony features, and pattern of biochemical profiles, together with conventional microbiological procedures, were used to identify all significant positive cultures of bacteriuria (>105 CFU colonies) at the species level. In this study out of 103 isolates 79 isolates were gram negative & 24 were Gram positive. Out of seventy-nine gram negative isolates the major contribution was by Escherichia coli (36), Klebsiella spp. (26). Among 24 gram positive isolates, the major contribution was by Coagulase Negative Staphylococci (CONS) (12).

This study results were supported by Ali, A.H et al study demonstrated that “most of the gram negative were sensitive to meropenem (95.9%), ceftriaxone (79.6%), Norfloxacin (77.5%), gentamicin (75.5%), nitrofurantoin (75.5%) and ciprofoxacin (71.4%), and were resistance to tetracycline (71.4%), trimethoprim–sulfamethoxazole (57.1%), amoxicillin clavulanic acid (55.1%) and nalidixic acid (51%).19 Analogous research conducted in diverse geographical area like in Addis Ababa, Ethiopia that showed highly sensitive to meropenem (75.2%), nitrofurantoin (93.1%), gentamicin (85.2%), ceftriaxone (82.2%), cefuroxime (79.3%), and ciprofloxacin (75.2%).20

The evaluated sensitivity of Escherichia coli was grater with, Meropenem (10 μg), Nitrofurantoin (300 μg), Ceftriaxone (30 μg), co-trimoxazole (1.25 - 23.75μg), Norfloxacin (10 μg), Azithromycin (15 μg) Gentamicin (10 μg), Ciprofloxacin (5 μg). E coli showed resistance to Amoxycillin (10 μg), Tetracycline (30 μg) and the sensitivity was moderate to Amoxycillin-Clavulinic Acid. In contrast Belete MA et al study showed increased E. coli resistant to gentamicin, sulfamethoxazole, Trimethoprim, Nitrofurantoin, Norfloxacin, Ciprofloxacin, ampicillin, Ceftriaxone, amoxicillin, and nalidixicacid (20). This may be the usage of antibacterial at that particular geographical area.

The strains in the strains in the Klebsiella species of this study were sensitive to co-trimoxazole (1.25 23.75μg), Azithromycin (15 μg), Norfloxacin (10 μg), Meropenem (10 μg), Ceftriaxone (30 μg), Gentamicin (10 μg), Ciprofloxacin (5 μg), Nitrofurantoin (300 μg). Klebsiella spices demonstrated intermediate sensitivity to Amoxycillin-Clavulinic Acid, and were highly resistant to Tetracycline (30 μg), Amoxycillin (10 μg). This was supported with little variation by Johnson B et al. and, Moyo SJ et al. studies.21, 22 The findings of Derese et al. study stated that Klebsiella species were entirely (100%) resistant to amoxicillin, ampicillin, and nitrofurantoin, nevertheless 66.7% of bacteria were resistant to tetracycline, and chloramphenicol.12

According to current study among the Gram Positive bacteria Coagulase Negative Staphylococci (CONS) is a foremost bacterium perceived in the current research study was sensitive to Nitrofurantoin (300 μg), Azithromycin (15 μg), co-trimoxazole, Ceftriaxone (30 μg), Meropenem (10 μg), Gentamicin (10 μg), Norfloxacin (10 μg), Ciprofloxacin (5 μg) and resistant to Amoxycillin (10 μg), Tetracycline (30 μg), Amoxycillin-Clavulinic Acid. This study was supported by Aseffa, A et al by stating that CoNS was the foremost gram positive bacterium (55%) was found 63% to 81% sensitive to erythromycin, cefriaxone, cefoxitin, nitrofurantoin, ciprofloxacin, and gentamicin. However the study conducted in Ethiopia was shown Cons resistant to nitrofurantoin (26.7%).8, 23 According to Shaheen et al study, CoNS is exceedingly unaffected with ampicillin (81.8%), tetracycline (54.5%), and amoxicillin clavulanic acid (45.4%) but affected by cefoxitin (81.8%), erythromycin (81.8%), nitrofurantoin (72.7%), ceftriaxone (72.7%) and gentamicin (72.7%), ciprofloxacin (63.6%) and co-trimoxazole (54.5%).19

Conclusion

This study demonstrated and supported that the antibacterial susceptibility and resistant of uropathogens may be vary in different geographical areas based on the antibiotic usage, and also demonstrated the imperative prerequisite of periodic assessments to determine the susceptibility configurations of bacteria that are responsible for bacteriuria in pregnant women. Operative health policies have to be designed to reduce irrational use of antibiotics and to provide revised strategies on empiric management of UTIs in pregnant women. There should be practices to educate antibiotic usage in pregnant women and to prevent prior usage of antibiotics to its susceptibility test.

Source of Funding

None.

Conflict of Interest

No.

References

1 

P Pritam Prevalence of urinary tract infections and current scenario of antibiotic susceptibility pattern of bacteria causing UTIIndian J Microbiol Res2020533348

2 

M Amiri Z Lavasani R Norouzirad R Najibpour M Mohamadpour AR Nikpoor Prevalence of Urinary Tract Infection Among Pregnant Women and its Complications in Their Newborns During the Birth in the Hospitals of Dezful City, Iran, 2012 - 2013Iran Red Crescent Med J2015178e26946

3 

A Muhammad SN Khan N Ali MU Rehman I Ali Prevalence and antibiotic susceptibility pattern of uropathogens in outpatients at a tertiary care hospitalNew Microbes New Infect202036100716

4 

RJ Baer N Nidey G Bandoli BD Chambers CD Chambers S Feuer Risk of Early Birth among Women with a Urinary Tract Infection: A Retrospective Cohort StudyAJP Rep2021111514

5 

J Kaduma J Seni C Chuma R Kirita F Mujuni MF Mushi Urinary Tract Infections and Preeclampsia among Pregnant Women Attending Two Hospitals in Mwanza City, Tanzania: A 1:2 Matched Case-Control StudyBioMed Res Int201920193937812

6 

MK Krischak HA Rosett S Sachdeva KE Weaver RP Heine AE Denoble Beyond Expert Opinion: A Comparison of Antibiotic Regimens for Infectious Urinary Tract Pathology in PregnancyAm J Perinatol Rep202010043526

7 

S Angami N Jamir P Sarma A Deka Urinary tract infection, its causative microorganism and antibiotic susceptibility in NagalandArch Med Health Sci20153140

8 

BA Tantry S Rahiman Antibacterial resistance and trend of urinary tract pathogens to commonly used antibiotics in Kashmir ValleyWest Indian Med J20126177037

9 

M Cheesbrough District Laboratory Practice in Tropical Countries2nd edCambridge University PressUnited Kingdom2006https://www.cambridge.org/core/product/identifier/9780511543470/type/book

10 

AW Bauer WM Kirby JC Sherris M Turck Antibiotic susceptibility testing by a standardized single disk methodAm J Clin Pathol19664544936

11 

MP Weinstein Performance standards for antimicrobial susceptibility testing30th edClinical and Laboratory Standards InstituteWayne, Pennsylvania2020

12 

B Derese H Kedir Z Teklemariam F Weldegebreal S Balakrishnan Bacterial profile of urinary tract infection and antimicrobial susceptibility pattern among pregnant women attending at Antenatal Clinic in Dil Chora Referral Hospital, Dire Dawa, Eastern EthiopiaTher Clin Risk Manag20161225160

13 

M Widmer I Lopez AM Gülmezoglu L Mignini A Roganti Duration of treatment for asymptomatic bacteriuria during pregnancyCochrane Database Syst Rev2015201511CD000491

14 

H Patel S Soni A Bhagyalaxmi N Patel Causative agents of urinary tract infections and their antimicrobial susceptibility patterns at a referral center in Western India: An audit to help clinicians prevent antibiotic misuseJ Family Med Prim Care2019811549

15 

S Farajnia MY Alikhani R Ghotaslou B Naghili A Nakhlband Causative agents and antimicrobial susceptibilities of urinary tract infections in the northwest of IranInt J Infect Dis20091321404

16 

A Matalka N Al-Husban O Alkuran L Almuhaisen A Basha M Eid Spectrum of uropathogens and their susceptibility to antimicrobials in pregnant women: a retrospective analysis of 5-year hospital dataJ Int Med Res20214953000605211006540

17 

HD Souza GRM Diório SV Peres RPV Francisco MAK Galletta Bacterial profile and prevalence of urinary tract infections in pregnant women in Latin America: a systematic review and meta-analysisBMC Pregnancy Childbirth2023231774

18 

MA Belete M Saravanan A Systematic Review on Drug Resistant Urinary Tract Infection Among Pregnant Women in Developing Countries in Africa and Asia; 2005-2016Infect Drug Resist200513146577

19 

AH Ali DY Reda MD Ormago Prevalence and antimicrobial susceptibility pattern of urinary tract infection among pregnant women attending Hargeisa Group Hospital, Hargeisa, SomalilandSci Rep20221211419

20 

YA Wabe DY Reda ET Abreham DB Gobene MM Ali Prevalence of Asymptomatic Bacteriuria, Associated Factors and Antimicrobial Susceptibility Profile of Bacteria Among Pregnant Women Attending Saint Paul's Hospital Millennium Medical College, Addis Ababa, EthiopiaTher Clin Risk Manag20201692332

21 

B Johnson BM Stephen N Joseph O Asiphas K Musa K Taseera Prevalence and bacteriology of culture-positive urinary tract infection among pregnant women with suspected urinary tract infection at Mbarara regional referral hospital, South-Western UgandaBMC Pregnancy Childbirth2021211159

22 

SJ Moyo S Aboud M Kasubi EF Lyamuya SY Maselle Antimicrobial resistance among producers and non-producers of extended spectrum beta-lactamases in urinary isolates at a tertiary Hospital in TanzaniaBMC Res Notes201031348

23 

A Aseffa R Abubeker N Asemene S Fentew A Mihret D Beyene Bacteriological profile and antibiotic resistance pattern of urinary tract pathogens isolated at National Referral Laboratory, Ethiopian Public Health InstituteEthiop J Public Health Nutr20182211923



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Article type

Original Article


Article page

431-437


Authors Details

Hakeem Sayeda Bee Bee Hajira, Hassan Shaikh Imrana, Sadgunothama Goud Kamparj*


Article History

Received : 07-02-2024

Accepted : 18-04-2024


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