Symptomatic and asymptomatic bacteriuria and antimicrobial susceptibility pattern among pregnant women in Kuwait

During pregnancy, physiological changes predispose women to urinary tract infections. This study aimed to evaluate the prevalence of asymptomatic bacteriuria, antimicrobial susceptibility patterns, and associated risk factors among pregnant women. Three hundred urine samples were collected from pregnant women attending Professional We Care Poly Clinic, Sabah Al-Salem area, Kuwait, between January and November 2023. Samples were cultivated on cystine lactose electrolyte deficient agar (CLED) media. Bacterial isolates were identified and antimicrobial susceptibility determined using the automated Vitek2 system and disc diffusion method on Muller-Hinton agar. The infection rate among participants was 71.33% (95% Confidence Interval (CI): 68.18-73.12%), representing 214 of 300 women. Among those examined, asymptomatic bacteriuria was identified in 51.39% (95% CI: 49.27-53.15%), corresponding to 154 cases, while symptomatic bacteriuria was observed in 19.98% (95% CI: 16.18-22.11%) of all participants. The predominant isolate was Escherichia coli (34.58%), followed by Candida sp. (17.76%), Streptococcus agalactiae (15.89%), Klebsiella pneumoniae (12.62%), and Enterococcus faecalis (11.21%). Gram-negative bacteria exhibited high resistance rates to tetracycline (96.4%) and ampicillin (90.5%). Multidrug-resistant (MDR) bacterial isolates were prevalent in 83.9% (94/112) of Gram-negative bacteria and 37.5% (42/64) of Gram-positive bacteria. Extended-spectrum beta-lactamase (ESβL) production was observed in 8.9% of Gram-negative isolates. A significant presence of bacteriuria exists in asymptomatic pregnant women, with considerable antimicrobial resistance to commonly prescribed agents. Routine screening and antimicrobial susceptibility testing are recommended for appropriate management of bacteriuria during pregnancy.