Author(s)

Mei-Fong Chou¹, Chau-Sha Kwok², Chon-Kit Ieong³, Sai-Meng Pang²

¹Department of Areia Preta Health Center, Macau, China.
²Alameda Dr. Carlos d’Assumpcao, Macau, China.
³Centro Hospitalar Conde de Sao Januário, CHCSJ, Macau, China.

Both asymptomatic (ASB) and symptomatic bacteriuria during pregnancy increase the risk of adverse fetal or maternal outcomes. Our study aims to determine the prevalence of bacteriuria, the etiological agents with their susceptibility to antimicrobials, and the risk factors for therapeutic failure among pregnant women for antenatal care in the primary health care of Macau, China. Methods: This is a cross-sectional survey involving 5101 antenatal care pregnant women from 1^st Jan to 31^st Dec., 2017. The mid-stream clean-catch urine specimens were routinely examined microscopically and cultured following the first consultation. Other data were collected from the computerized medical records. Results: The mean age of the pregnant women was 31.4 ± 5.04 years. We followed 130 women with positive cultures on first consultation, of whom 35 (26.9%) were found to have contaminated cultures. 95 pregnant women were confirmed to have UTI. The prevalence of bacteriuria was 1.86% (n = 95), of which 83 (87.4%) were asymptomatic. ASB was mainly in the younger age-group (20 - 30 years) and the primipara. Of 196 positive cultures, the commonest bacterium was Escherichia coli (n = 111 or 56.6%, 98.2% susceptible to nitrofurantoin), followed by Klebsiella pneumonia (n = 20 or 10.2%, 90% susceptible to 2^nd generation cephalosporin), and Streptococcus agalactiae (n = 16 or 8.2%, 100% susceptible to nitrofurantoin). After treatment, there were 80 (84.2%) therapeutic successes and 15 (15.8%) failures. Symptomatic infection and later trimester were significantly associated with therapeutic failure (P ≤ 0.05). Conclusions: ASB is common in the young age group and primipara. Nitrofuranton and 2^nd generation cephalosporin are effective antibiotics against UTI in pregnancy. Symptomatic infection and occurrence in later trimester were significantly associated with treatment failure.

Pregnancy, Asymptomatic Bacteriuria (ASB), Symptomatic Bacteriuria (SB), Primary Health Care, Antenatal Care

Chou, M. , Kwok, C. , Ieong, C. and Pang, S. (2019) Antimicrobial Susceptibility Pattern of Bacteriuria and Risks of Therapeutic Failure among Pregnant Women in Primary Health Care of Macau, China. Open Journal of Obstetrics and Gynecology, 9, 1347-1357. doi: 10.4236/ojog.2019.910130.