Urinary Pathogens amongst Parturients at the University of Port Harcourt Teaching Hospital, South-South, Nigeria

Abstract

Aim: To identify the microorganisms in urine before and after delivery. Also, to identify the incidence, risk factors and antibiotic susceptibility pattern in postpartum bacteriuria.      Methods: A quasi-interventional study of 50 women who had term vaginal deliveries at the University of Port Harcourt Teaching Hospital (UPTH) Nigeria, between September 1, 2016 and December 31, 2016. Clean catch midstream urine samples collected in sterile containers from parturients before and after delivery were processed. All significant isolates were subjected to antimicrobial susceptibility testing. Socio-demographic data and data regarding labour and risk factors were collected on a pre-designed proforma and entered on a spread sheet. Statistical analysis was done using SPSS version 22.0. Results: Majority 49 (98%) of the parturients were booked (women that received antenatal care). Eight (16%) of the parturients had bacteriuria pre and post-delivery. Four of the parturients who were negative for bacteriuria before delivery had postpartum bacteria, giving an incidence of 8% for postpartum bacteriuria. The commonest micro-organism isolated post-delivery was Escherichia coli (50%). The number of vaginal examinations, vacuum delivery, episiotomy, perineal tear and bladder catheterization did not significantly increase the risk of postpartum bacteriuria. Conclusion: Escherichia coli is the most common urinary pathogens and sensitive to Nalidixic acid. Routine screening of women for bacteriuria after delivery and an understanding of the antimicrobial sensitivity will help in reducing associated morbidities.