The Prevalence of Asymptomatic Bacteriuria Among Jordanian Pregnant Women

Abstract

Objective: Asymptomatic bacteriuria (ASB) is common in pregnant women and can lead to serious complications. During pregnancy, routine screening for bacteriuria is often not standard in many developing countries, leading to underdiagnosis. In Jordan, there is limited data on ASB in pregnant women. This study aimed to determine the prevalence, causative organisms, antibiotic sensitivity, and associations with maternal conditions and diseases. Methods: This cross-sectional, prospective study conducted at Jordan University Hospital assessed the prevalence of ASB in pregnant women. Pregnant women aged ≥18 years at any trimester, without symptoms of urinary tract infection, and who had not utilized antibiotics for two weeks, were included. Midstream urine samples were collected, analyzed, cultured, and tested for antibiotic susceptibility in the hospital’s Microbiology laboratory. Results: Out of 319 women, 23.5% (n=76) showed positive urine culture. The chi-square and logistic regression analysis revealed that gestational age and grand multipara were associated with ASB. Neither diabetes nor hypertension (true or gestational) was associated with ASB. Fifty-one of the bacteriuria cases (68%) were positive for pure culture of Escherichia coli, and 4% were mixed with Gram-positive organisms. ASB due to Gram-negative organisms was significantly associated with older age group (p = 0.025). Furthermore, the antibiotic sensitivities of the isolated E. coli showed high percentages (≥90%) to nitrofurantoin, aminoglycosides, and some types of cephalosporins, but low (56%) to amoxicillin-clavulanic acid. Conclusion: The prevalence of ASB among Jordanian women was higher than in developed countries and some low-to-middle-income countries, and ASB was significantly associated with gestational age and parity. These findings emphasized the importance of routine screening for ASB during pregnancy, particularly in the third trimester and in grand multiparous women. Although no significant association was found with maternal age or common comorbidities such as diabetes and hypertension, further extensive studies are needed.