Asymptomatic Bacteriuria in Pregnant and Diabetic Women

Abstract

Background: Asymptomatic bacteriuria (ASB) is
defined as isolation of a specified quantitative count
of bacteria in an appropriately collected urine
specimen from an individual without symptoms or
signs of urinary tract infection.
Aim of study: To evaluate the frequency of
bacteriuria according to age, pregnancy, and type II
diabetes mellitus in a sample of Iraqi women.
Patients and Methods: A total of 125 female
individuals were involved. The study participants
were classified into the following groups: nonpregnant
women with type II diabetes mellitus,
pregnant women with type II diabetes mellitus,
pregnant women without type II diabetes mellitus, and
apparently healthy non-pregnant women. Urine and
blood specimens were tested to record positive urine
culture, pyuria, and blood glucose according to
standard microbiological and biochemical methods.
Results: Frequency of positive urine culture and
pyuria in the total pregnant women was 7 (14%) and
15 (30%), respectively, whereas frequency of positive
urine culture and pyuria in the total diabetic women
was 8 (16%) and 23 (46%), respectively. The bacterial
isolation rate in the studied groups was 13 (10%). Ecoli
recorded the highest isolation rate, 6(5%). There
was no significant culture positive of urine specimens
in the groups of diabetic non-pregnant, diabetic
pregnant, and women with normal pregnancy (Pvalue<
0.05). Pregnant women with culture positive
urine and pyuria were more likely to have perinatal
mortality. Sterile pyuria was detected in pregnant
women aged 18-45, those in third trimester, and in
multiparous pregnant women. There was significant
positive urine culture and a highly significant pyuria
in diabetic women with BMI > 25.
Conclusions: Asymptomatic bacteriuria is an
independent risk factor for perinatal mortality. Sterile
pyuria is a significant observation in pregnant and
diabetic women; therefore it should bring more
attention.
Recommendations Treatment of asymptomatic
bacteriuria is appropriate for pregnant women but it is
not recommended for diabetics. The study advised to
perform urine culture as a part of the antenatal checkup
for pregnant women.