الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Urinary tract infection represents the most common medical complication of pregnancy. Pregnant women are at greater risk of UTIs, particularly because of the physiologic and anatomic changes that occur normaly during pregnancy resulting in maternal morbidity and fetal outcomes. The present study was conducted to determine the bacterial profile of urinary tract infection among pregnant women attending outpatient antenatal care clinic complaining or not complaining of UTI symptoms using two different culture media.
These cross sectional study was carried out on 200 pregnant women attending outpatient antenatal care clinics at El-Shatby hospital for Obstetrics and Gynecology, Alexandria University, Egypt. Data were collected using Predesigned structured interviewing questionnaire during the period from September 2017 to February 2018.
Clean catch mid stream urine samples were collected from all participants and transported immediately to the Microbiology Laboratory at the HIPH. Semiquantitative urine Culture procedure was done using a calibrated loop, urine was streaked for count on CLED agar and HiCrome UTI agar plates and incubated aerobically at 37°C for 24 hours. All isolated bacteria were examined morphologically and further identified by biochemical tests.
All identified bacterial isolates were subjected to antimicrobial susceptibility testing using the disc diffusion method described by Kirby and Bauer on Mueller Hinton agar plates. Inhibition zone were measured, recorded and interpreted according to the CLSI tables.
The results of this study can be summarized as follow:
1. Of the 200 examined urine sample 131 sample (65.5%) had negative urine culture and 69 sample had positive urine culture which amounted to a prevalence of 34.5%.
2. Among pregnant women patients higher prevalence was observed in the age group of >30 years (43.5%) were found to be statistically significant, due to P- value less than 0.05.
3. The prevalence rate of the pregnant patients in relation to the trimester of pregnancy was higher in the third trimester (52.13%) compared to the first (16.23%) and second (31.62%) trimesters, however these results were statistically non significant.
4. The current study revealed that, there was significant association between unsatisfactory personal hygiene and poor hygienic practices such as delayed post coitus washing, no drying after voiding and those mothers who usually use underwear clothes other than cotton were significantly associated with UTI occurrence
Summary and Conclusion
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5. There was a moderate agreement detected between pyuria and culture positivity.
6. E.coli was the most frequently encountered isolate 31.9% followed by K. pneumonia 30.4% and each showed the highest sensitivity to fosfomycin (100%).
7. E.fecalis was the third encountered isolates with a prevalence of 17.4 % ,all were susceptible to fosfomycin, ciprofloxacin and vancomycin 100%.
8. S. aureus and S. saprophiticus showed a prevalence of 7.2% for each followed by E. aerogenes showed 4.3% prevalence. Proteus vulgaris was the least encountered isolates 1.4%.
9. The chromogenic agar media allowed the growth and primary identification in all samples. The different coloured colonies produced by the breakdown of the chromogenic substrate by the specific enzymes of the bacteria were useful in the presumptive identification of these organisms even from polymicrobial cultures.
It can be concluded from this study that :
1. There was a significant association between unsatisfactory personal hygiene and culture positivity.
2. There was a significant difference in the prevalence of bacteriuria with respect to age.
3. The relationship between pyuria and culture positivity showed moderate agreement.
4. E.coli was the most frequently encountered organism isolated from all studied samples.
5. The different coloured colonies produced by the breakdown of the chromogenic substrate by the specific enzymes of the bacteria were useful in the presumptive identification of these organisms even from polymicrobial cultures.
6. HiCrome UTI agar media can be used as an acceptable alternative to traditional media for the isolation of urinary pathogens.