Abstract:

Background: The prevalence of significant bacteriuria in pregnant women who are infected by Human Immunodefiency Virus (HIV ranges from 8-18% with majority being from Sub Saharan Africa. Untreated significant bacteriuria can leads to adverse maternal and pregnancy outcomes. However the prevalence, antimicrobial susceptibility patterns and associated factors of significant bacteriuria among HIV infected pregnant women in our setting is not known.

Objective: To determine to prevalence, antimicrobial susceptibility patterns and predictors of asymptomatic and symptomatic bacteriuria among HIV infected pregnant women attending prevention of maternal to child HIV transmission (PMTCT) clinics at Bugando Medical Centre, Sekou Toure Hospital, Nyamagana District Hospital, Makongoro and Buzuruga Health Centre’s.

Methodology: A cross sectional hospital based study involving 234 HIV infected pregnant women in PMTCT clinics in Mwanza City was conducted between March 2016 and May 2016. All HIV infected pregnant women with and without symptoms and signs of urinary tract symptoms (UTI) were enrolled into the study. A structured pre-tested questionnaire was used to obtain socio-demographic, clinical and obstetric information. For each participant mid stream urine (MSU) was collected and processed according to the standard operating procedures to determine the presence of significant bacteriuria and antimicrobial susceptibility patterns. Data was analyzed by STATA version 11.0

Results: The mean age of the enrolled women was 28.6±5.5 years. The prevalence of significant bacteriuria in HIV infected pregnant women was 50/234, 21.4% (95%CI: 16.11-26.6). Marital status (O.R; 2.61, 95% CI: 1.12-6.09, p=0.026), low CD4 counts (O.R; 2.92, 95% CI: 1.10-7.71, p=0.031) and presence of UTI symptoms (O.R; 2.52, 95% CI: 0.60-8.29, p=0.03) were found to predict significant bacteriuria among HIV infected pregnant women. A total of 52 bacteria isolates were recovered with Escherichia coli (57.69%) and Klebsiella pneumonia (23.08%) being the most predominant isolates. Escherichia coli exhibited high resistance to ampicillin (93.3%) and trimethoprim-sulfamethoxazole (90%); compared to nitrofurantoin (16.7%), gentamicin (10%) and Ceftriaxone (10%).

Conclusion: A Considerable proportion of HIV infected pregnant women in Mwanza had significant bacteriuria that calls for the need to introduce routine screening at booking and specific treatment of these women so as to prevent associated complications.