Asymptomatic bacteriuria and its associated fetomaternal outcomes among pregnant women delivering at Bugando Medical Centre in Mwanza, Tanzania
Asymptomatic bacteriuria (ASB) affects 23.9% of pregnant women globally and, if left untreated, can lead to adverse fetomaternal outcomes. In Tanzania, ASB prevalence has ranged from 13% to 17% over the past decade. Yet, its impact on fetomaternal outcomes remains unexplored, hindering the developme...
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| description | Asymptomatic bacteriuria (ASB) affects 23.9% of pregnant women globally and, if left untreated, can lead to adverse fetomaternal outcomes. In Tanzania, ASB prevalence has ranged from 13% to 17% over the past decade. Yet, its impact on fetomaternal outcomes remains unexplored, hindering the development of screening strategies, antimicrobial therapies, and preventive measures for this vulnerable population.
A cross-sectional analytical study was conducted on 1,093 pregnant women admitted for delivery at Bugando Medical Center (BMC) in Mwanza, Tanzania, from July to December 2022. Socio-demographic, obstetric, and clinical data were collected from the women, along with mid-stream urine samples for analysis. Fetomaternal outcomes were assessed within 72 hours after delivery.
The median age of participants was 29 years (range: 15-45 years). ASB prevalence among pregnant women was 16.9% (185/1093), with a 95% CI of 14.6-19.3%. Risk factors for ASB included anemia (OR: 5.3; 95% CI = 3.7-8.2, p-value |
| doi_str_mv | 10.1371/journal.pone.0303772 |
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A cross-sectional analytical study was conducted on 1,093 pregnant women admitted for delivery at Bugando Medical Center (BMC) in Mwanza, Tanzania, from July to December 2022. Socio-demographic, obstetric, and clinical data were collected from the women, along with mid-stream urine samples for analysis. Fetomaternal outcomes were assessed within 72 hours after delivery.
The median age of participants was 29 years (range: 15-45 years). ASB prevalence among pregnant women was 16.9% (185/1093), with a 95% CI of 14.6-19.3%. Risk factors for ASB included anemia (OR: 5.3; 95% CI = 3.7-8.2, p-value <0.001) and a history of antenatal care admission (OR 4.2; 95% CI = 2.9-6.1, p-value <0.001). Among all participants, 82 (7.5%), 65 (5.9%), 49 (4.5%), and 79 (7.2%) experienced pre-term labor (PTL), premature rupture of membrane (PROM), preeclampsia, and delivered newborns with low birthweight (LBW), respectively. Among the 185 patients with ASB, the respective proportions of PTL, PROM, preeclampsia, and LBW were 25.4%, 17.3%, 9.2%, and 12.4%. Multivariable logistic regression analysis revealed significant associations between ASB and PTL [OR (95% CI): 8.8 (5.5-14.5); p-value <0.001], PROM [OR (95% CI): 4.5 (2.5-8.0); p-value <0.001], and LBW [OR (95% CI): 2.0 (1.2-3.5); p-value = 0.011]. Escherichia coli (50.8%) and Klebsiella pneumoniae (14.05%) were the most common pathogens, with low resistance rates to nitrofurantoin, amoxicillin-clavulanate, and cephalosporins-antibiotics considered safe during pregnancy-ranging from 8.2% to 31.0%.
The prevalence of ASB among pregnant women in Tanzania remains high and is associated with adverse fetomaternal outcomes. Integrating routine urine culture screening for all pregnant women, irrespective of symptoms, and providing specific antimicrobial therapies during antenatal care can help prevent adverse pregnancy outcomes.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0303772</identifier><identifier>PMID: 39361620</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Adolescent ; Adult ; Amoxicillin ; Anemia ; Antibiotics ; Asymptomatic ; At risk populations ; Bacteria ; Bacteria in the urine ; Bacterial pneumonia ; Bacteriuria ; Bacteriuria - drug therapy ; Bacteriuria - epidemiology ; Bacteriuria - microbiology ; Biology and Life Sciences ; Birth weight ; Bladder ; Care and treatment ; Cephalosporins ; Childbirth & labor ; Complications and side effects ; Cross-Sectional Studies ; Development and progression ; Diabetes ; Diagnosis ; Drug resistance in microorganisms ; E coli ; Female ; Health aspects ; Health care facilities ; Humans ; Infant, Newborn ; Infants (Newborn) ; Informed consent ; Klebsiella ; Low resistance ; Medical centers ; Medicine and Health Sciences ; Methicillin ; Middle Aged ; Neonates ; Nitrofurantoin ; Normal distribution ; Obstetrics ; Pathogens ; Physiology ; Pneumonia ; Population studies ; Pre-eclampsia ; Preeclampsia ; Pregnancy ; Pregnancy complications ; Pregnancy Complications, Infectious - epidemiology ; Pregnancy Complications, Infectious - microbiology ; Pregnancy Outcome - epidemiology ; Pregnant women ; Prenatal care ; Prevalence ; Prevention ; Regression analysis ; Research and Analysis Methods ; Risk Factors ; Sample size ; Sociodemographics ; Tanzania - epidemiology ; Tazobactam ; Urinary tract diseases ; Urinary tract infections ; Urine ; Urogenital system ; Uterus ; Young Adult</subject><ispartof>PloS one, 2024-10, Vol.19 (10), p.e0303772</ispartof><rights>Copyright: © 2024 Mayomba et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.</rights><rights>COPYRIGHT 2024 Public Library of Science</rights><rights>2024 Mayomba et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2024 Mayomba et al 2024 Mayomba et al</rights><rights>2024 Mayomba et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c506t-1603a48d30140fb52090a7a3fb07b2ef5595b042c8f14ae98793b6015d67eb273</cites><orcidid>0000-0003-1048-6166</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11449372/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11449372/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2915,23845,27901,27902,53766,53768,79343,79344</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39361620$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Mayomba, Colman</creatorcontrib><creatorcontrib>Matovelo, Dismas</creatorcontrib><creatorcontrib>Kiritta, Richard</creatorcontrib><creatorcontrib>Kashinje, Zengo</creatorcontrib><creatorcontrib>Seni, Jeremiah</creatorcontrib><title>Asymptomatic bacteriuria and its associated fetomaternal outcomes among pregnant women delivering at Bugando Medical Centre in Mwanza, Tanzania</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Asymptomatic bacteriuria (ASB) affects 23.9% of pregnant women globally and, if left untreated, can lead to adverse fetomaternal outcomes. In Tanzania, ASB prevalence has ranged from 13% to 17% over the past decade. Yet, its impact on fetomaternal outcomes remains unexplored, hindering the development of screening strategies, antimicrobial therapies, and preventive measures for this vulnerable population.
A cross-sectional analytical study was conducted on 1,093 pregnant women admitted for delivery at Bugando Medical Center (BMC) in Mwanza, Tanzania, from July to December 2022. Socio-demographic, obstetric, and clinical data were collected from the women, along with mid-stream urine samples for analysis. Fetomaternal outcomes were assessed within 72 hours after delivery.
The median age of participants was 29 years (range: 15-45 years). ASB prevalence among pregnant women was 16.9% (185/1093), with a 95% CI of 14.6-19.3%. Risk factors for ASB included anemia (OR: 5.3; 95% CI = 3.7-8.2, p-value <0.001) and a history of antenatal care admission (OR 4.2; 95% CI = 2.9-6.1, p-value <0.001). Among all participants, 82 (7.5%), 65 (5.9%), 49 (4.5%), and 79 (7.2%) experienced pre-term labor (PTL), premature rupture of membrane (PROM), preeclampsia, and delivered newborns with low birthweight (LBW), respectively. Among the 185 patients with ASB, the respective proportions of PTL, PROM, preeclampsia, and LBW were 25.4%, 17.3%, 9.2%, and 12.4%. Multivariable logistic regression analysis revealed significant associations between ASB and PTL [OR (95% CI): 8.8 (5.5-14.5); p-value <0.001], PROM [OR (95% CI): 4.5 (2.5-8.0); p-value <0.001], and LBW [OR (95% CI): 2.0 (1.2-3.5); p-value = 0.011]. Escherichia coli (50.8%) and Klebsiella pneumoniae (14.05%) were the most common pathogens, with low resistance rates to nitrofurantoin, amoxicillin-clavulanate, and cephalosporins-antibiotics considered safe during pregnancy-ranging from 8.2% to 31.0%.
The prevalence of ASB among pregnant women in Tanzania remains high and is associated with adverse fetomaternal outcomes. Integrating routine urine culture screening for all pregnant women, irrespective of symptoms, and providing specific antimicrobial therapies during antenatal care can help prevent adverse pregnancy outcomes.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Amoxicillin</subject><subject>Anemia</subject><subject>Antibiotics</subject><subject>Asymptomatic</subject><subject>At risk populations</subject><subject>Bacteria</subject><subject>Bacteria in the urine</subject><subject>Bacterial pneumonia</subject><subject>Bacteriuria</subject><subject>Bacteriuria - drug therapy</subject><subject>Bacteriuria - epidemiology</subject><subject>Bacteriuria - microbiology</subject><subject>Biology and Life Sciences</subject><subject>Birth weight</subject><subject>Bladder</subject><subject>Care and treatment</subject><subject>Cephalosporins</subject><subject>Childbirth & labor</subject><subject>Complications and side effects</subject><subject>Cross-Sectional Studies</subject><subject>Development and progression</subject><subject>Diabetes</subject><subject>Diagnosis</subject><subject>Drug resistance in microorganisms</subject><subject>E coli</subject><subject>Female</subject><subject>Health aspects</subject><subject>Health care facilities</subject><subject>Humans</subject><subject>Infant, Newborn</subject><subject>Infants (Newborn)</subject><subject>Informed consent</subject><subject>Klebsiella</subject><subject>Low resistance</subject><subject>Medical centers</subject><subject>Medicine and Health Sciences</subject><subject>Methicillin</subject><subject>Middle Aged</subject><subject>Neonates</subject><subject>Nitrofurantoin</subject><subject>Normal distribution</subject><subject>Obstetrics</subject><subject>Pathogens</subject><subject>Physiology</subject><subject>Pneumonia</subject><subject>Population studies</subject><subject>Pre-eclampsia</subject><subject>Preeclampsia</subject><subject>Pregnancy</subject><subject>Pregnancy complications</subject><subject>Pregnancy Complications, Infectious - epidemiology</subject><subject>Pregnancy Complications, Infectious - microbiology</subject><subject>Pregnancy Outcome - epidemiology</subject><subject>Pregnant women</subject><subject>Prenatal care</subject><subject>Prevalence</subject><subject>Prevention</subject><subject>Regression analysis</subject><subject>Research and Analysis Methods</subject><subject>Risk Factors</subject><subject>Sample size</subject><subject>Sociodemographics</subject><subject>Tanzania - epidemiology</subject><subject>Tazobactam</subject><subject>Urinary tract diseases</subject><subject>Urinary tract infections</subject><subject>Urine</subject><subject>Urogenital system</subject><subject>Uterus</subject><subject>Young Adult</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNqNkt1u1DAQhSMEoqXwBggsISGQ2MWOkzi5QsuKn0qtKkHh1po4k6yrxA6x01JeglfGYdNqF_UC-cKR5ztnRpMTRU8ZXTIu2NsLOw4G2mVvDS4pp1yI-F50yAoeL7KY8vs73wfRI-cuKE15nmUPowNe8IyFwmH0e-Wuu97bDrxWpATlcdDjoIGAqYj2joBzVmnwWJEa_4I49SV29Mp2GIDOmob0AzYGjCdX4dGQClt9GaxCBTx5PzbBzpJTrLQK2jUaPyDRhpxegfkFb8j5dBkNj6MHNbQOn8z3UfTt44fz9efFydmn4_XqZKFSmvkFyyiHJK84ZQmtyzSmBQUBvC6pKGOs07RIS5rEKq9ZAljkouBlRllaZQLLWPCj6PnWt2-tk_MuneSMxaKgjNJAvJuJseywUtPI0Mp-0B0M19KClvsVozeysZeSsSQpuIiDw6vZYbA_RnRedtopbFswaMdtszzNRDKN8-If9O6RZqqBFqU2tQ2N1WQqVzljNEvCCdTyDiqcCjutQlpqHd73BK_3BIHx-NM3MDonj79--X_27Ps--3KH3SC0fuNsO3ptjdsHky2oBuvcgPXtlhmVU9hvtiGnsMs57EH2bPcP3Ypu0s3_ANeG-1I</recordid><startdate>20241003</startdate><enddate>20241003</enddate><creator>Mayomba, Colman</creator><creator>Matovelo, Dismas</creator><creator>Kiritta, Richard</creator><creator>Kashinje, Zengo</creator><creator>Seni, Jeremiah</creator><general>Public Library of Science</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0003-1048-6166</orcidid></search><sort><creationdate>20241003</creationdate><title>Asymptomatic bacteriuria and its associated fetomaternal outcomes among pregnant women delivering at Bugando Medical Centre in Mwanza, Tanzania</title><author>Mayomba, Colman ; Matovelo, Dismas ; Kiritta, Richard ; Kashinje, Zengo ; Seni, Jeremiah</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c506t-1603a48d30140fb52090a7a3fb07b2ef5595b042c8f14ae98793b6015d67eb273</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Amoxicillin</topic><topic>Anemia</topic><topic>Antibiotics</topic><topic>Asymptomatic</topic><topic>At risk populations</topic><topic>Bacteria</topic><topic>Bacteria in the urine</topic><topic>Bacterial pneumonia</topic><topic>Bacteriuria</topic><topic>Bacteriuria - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Mayomba, Colman</au><au>Matovelo, Dismas</au><au>Kiritta, Richard</au><au>Kashinje, Zengo</au><au>Seni, Jeremiah</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Asymptomatic bacteriuria and its associated fetomaternal outcomes among pregnant women delivering at Bugando Medical Centre in Mwanza, Tanzania</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2024-10-03</date><risdate>2024</risdate><volume>19</volume><issue>10</issue><spage>e0303772</spage><pages>e0303772-</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Asymptomatic bacteriuria (ASB) affects 23.9% of pregnant women globally and, if left untreated, can lead to adverse fetomaternal outcomes. In Tanzania, ASB prevalence has ranged from 13% to 17% over the past decade. Yet, its impact on fetomaternal outcomes remains unexplored, hindering the development of screening strategies, antimicrobial therapies, and preventive measures for this vulnerable population.
A cross-sectional analytical study was conducted on 1,093 pregnant women admitted for delivery at Bugando Medical Center (BMC) in Mwanza, Tanzania, from July to December 2022. Socio-demographic, obstetric, and clinical data were collected from the women, along with mid-stream urine samples for analysis. Fetomaternal outcomes were assessed within 72 hours after delivery.
The median age of participants was 29 years (range: 15-45 years). ASB prevalence among pregnant women was 16.9% (185/1093), with a 95% CI of 14.6-19.3%. Risk factors for ASB included anemia (OR: 5.3; 95% CI = 3.7-8.2, p-value <0.001) and a history of antenatal care admission (OR 4.2; 95% CI = 2.9-6.1, p-value <0.001). Among all participants, 82 (7.5%), 65 (5.9%), 49 (4.5%), and 79 (7.2%) experienced pre-term labor (PTL), premature rupture of membrane (PROM), preeclampsia, and delivered newborns with low birthweight (LBW), respectively. Among the 185 patients with ASB, the respective proportions of PTL, PROM, preeclampsia, and LBW were 25.4%, 17.3%, 9.2%, and 12.4%. Multivariable logistic regression analysis revealed significant associations between ASB and PTL [OR (95% CI): 8.8 (5.5-14.5); p-value <0.001], PROM [OR (95% CI): 4.5 (2.5-8.0); p-value <0.001], and LBW [OR (95% CI): 2.0 (1.2-3.5); p-value = 0.011]. Escherichia coli (50.8%) and Klebsiella pneumoniae (14.05%) were the most common pathogens, with low resistance rates to nitrofurantoin, amoxicillin-clavulanate, and cephalosporins-antibiotics considered safe during pregnancy-ranging from 8.2% to 31.0%.
The prevalence of ASB among pregnant women in Tanzania remains high and is associated with adverse fetomaternal outcomes. Integrating routine urine culture screening for all pregnant women, irrespective of symptoms, and providing specific antimicrobial therapies during antenatal care can help prevent adverse pregnancy outcomes.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>39361620</pmid><doi>10.1371/journal.pone.0303772</doi><tpages>e0303772</tpages><orcidid>https://orcid.org/0000-0003-1048-6166</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2024-10, Vol.19 (10), p.e0303772 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_3112790100 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; Free Full-Text Journals in Chemistry; Public Library of Science (PLoS) |
| subjects | Adolescent Adult Amoxicillin Anemia Antibiotics Asymptomatic At risk populations Bacteria Bacteria in the urine Bacterial pneumonia Bacteriuria Bacteriuria - drug therapy Bacteriuria - epidemiology Bacteriuria - microbiology Biology and Life Sciences Birth weight Bladder Care and treatment Cephalosporins Childbirth & labor Complications and side effects Cross-Sectional Studies Development and progression Diabetes Diagnosis Drug resistance in microorganisms E coli Female Health aspects Health care facilities Humans Infant, Newborn Infants (Newborn) Informed consent Klebsiella Low resistance Medical centers Medicine and Health Sciences Methicillin Middle Aged Neonates Nitrofurantoin Normal distribution Obstetrics Pathogens Physiology Pneumonia Population studies Pre-eclampsia Preeclampsia Pregnancy Pregnancy complications Pregnancy Complications, Infectious - epidemiology Pregnancy Complications, Infectious - microbiology Pregnancy Outcome - epidemiology Pregnant women Prenatal care Prevalence Prevention Regression analysis Research and Analysis Methods Risk Factors Sample size Sociodemographics Tanzania - epidemiology Tazobactam Urinary tract diseases Urinary tract infections Urine Urogenital system Uterus Young Adult |
| title | Asymptomatic bacteriuria and its associated fetomaternal outcomes among pregnant women delivering at Bugando Medical Centre in Mwanza, Tanzania |
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