TMSS Medical College Journal

Background: Urinary tract infection is a significant issue during pregnancy. Clinical symptoms can overlap with normal pregnancy-related changes. Therefore, lab confirmation is crucial. Aim of the study: This study aimed to assess the clinical presentation and urine culture results of UTI among symptomatic pregnant women. It also aimed to describe dipstick findings, isolated organisms, and patterns of antimicrobial susceptibility. Material and Methods: This cross-sectional descriptive study included 105 symptomatic pregnant women who visited the Department of Obstetrics and Gynecology at Shaheed Ziaur Rahman Medical College Hospital from January 2024 to December 2024. Researchers collected clinical and obstetric data. Urine samples underwent dipstick testing, culture, identification of organisms, and antimicrobial susceptibility testing. Data analysis utilized SPSS version 15.0. Fisher’s exact test assessed the association between dipstick and culture findings. Results: Of the 105 symptomatic pregnant women, 87.6% were under 25 years old, and the average gestational age was 24.67 ± 4.79 weeks. The most common symptoms were urinary frequency (98.1%) and burning sensation during urination (71.4%). Urine culture was positive in 6.7% of participants, with Escherichia coli found in all culture-positive cases. Dipstick positivity showed a significant association with culture-confirmed UTI (p<0.001). All E. coli isolates were sensitive to nitrofurantoin, 71.4% were sensitive to cephalexin, and only 14.3% were sensitive to amoxicillin. Conclusion: While urinary symptoms were common, only 6.7% of pregnant women had culture-confirmed UTI. Escherichia coli was the only isolated organism, showing the highest sensitivity to nitrofurantoin and considerable resistance to amoxicillin. Urine culture and susceptibility testing are vital for accurate diagnosis and appropriate treatment.

Urinary tract infection (UTI) is an important bacterial infection in pregnancy due to physiological and anatomical factors which promote ascending infection: dilatation of the ureters, reduced tone of the ureters, urinary stasis and incomplete bladder emptying. Infection can be either silent or symptomatic. and severe symptomatic infections usually have signs of dysuria (difficulty voiding), urinary frequency and urgency, suprapubic discomfort, fever, loin pain, nausea, or vomiting. Several of these manifestations may mimic normal pregnancy symptoms, so clinical evaluation alone may not be enough to establish the diagnosis and laboratory evaluation is especially crucial UTIs are a significant public-health problem worldwide, with an estimated 404.6 million cases in the general population in 2019, and pregnancy-specific prevalence rates are highly variable depending on the population, definition of UTI and setting in which the healthcare is provided.* In Latin America, a systematic review of the literature found that the prevalence of asymptomatic bacteriuria was 18.39%, the prevalence of lower UTI was 7.54%, and the prevalence of pyelonephritis was 2.34% in more than 111,000 pregnant women. The situation is also highly variable geographically within developing nations of Africa and Asia, with aggregated evidence suggesting some particularly high burdens in several low and middle income countries." A meta-analysis also showed significant heterogeneity for both symptomatic UTI and asymptomatic bacteriuria within Iran, as the local epidemiology is still essential’ In South Asia, the burden is clinically relevant because limitations in ‘microbiological facilities, empirical antibiotic use, and increasing antimicrobial resistance may complicate diagnosis and treatment. In rural Bangladesh, a population-based study of 4,242 pregnant women reported an overall UTI prevalence of 8.9%, comprising 4.4% symptomatic UTI and 4.5% asymptomatic bacteriuria." In neighbouring Pakistan, multidrug-resistant ~~ wropathogens have been documented among pregnant women, while studies from Ethiopia and Cameroon have reported substantial cultureconfirmed infection rates, illustrating pronounced setting-specific variation.