Advances in Life Science and Technology www.iiste.org ISSN 2224-7181 (Paper) ISSN 2225-062X (Online) Vol.35, 2015 38 Polymicrobial Agents and Antibiotic Profile of Urinary Tract Infections among Pregnant Women in Anambra State, Nigeria Mgbakogu, R.A. 1 Eledo, B.O. 2 1 Anambra State College of Health Technology Obosi. 2 Medical Laboratory Services, Federal Medical Centre, Yenagoa, Nigeria. Abstract Microbiological studies were carried out on midstream urine collected from 200 pregnant women(test) and 100 non pregnant women (control) attending antenatal clinics at General Hospital Onitsha, Enugwu-Ukwu and Chizoba Hospital Awada, Obosi. All the subjects were between 18-37years. The urine samples were cultured on to freshly prepared Eosine methylene blue (Oxoid), blood and MacConkey (Difco) agar plates and incubated at 37 oc for 24hours. Urinalysis using Combi-9 urine test strip and microscopic examination of the deposit were done. Organisms were identified using cultural characteristics, Gram staining reactions and some biochemical tests. Antibiotic sensitivity tests were carried out on isolates using agar diffusion methods. The result showed a prevalent rate of UTI in pregnancy 23(11.5%) and control 10(10%). There was no significant difference among pregnant and non- pregnant women p>0.05. Echerichia coli were the predominant organism isolated 78.26%, Group B streptococcus, Klebsiella spp and Staphylococuus saprophyticus were isolated 1 (4.3%) each, Proteus mirabilis were isolated 2(8.7%). In the control group E. coli were isolated 8 (80%) while Proteus and klebsiella were isolated 1(10%) each. All organisms isolated were 100% sensitive to gentamicin and nalidixic acid and 100% resistant to ampicillin. Keywords: Pregnancy, urinary tract infection, polymicrobial agents antibiotic profile INTRODUCTION The urinary tract consists of the various organs of the body (kidney, ureters, urethra and bladder) that produce, store and get rid of urine National Kidney and Urologic Disease Centre (2003). Normal urine is sterile- that is when cultured it is free of microbial agents National Kidney and Urologic Disease Centre (2003). The bladder has an excellent mechanism to keep it free of microbial agents via the hydrokinetic aspects which includes the periodic voiding of urine, constant dilution of urine in the bladder (Sobel et al., 1997) and microbial factors which includes effects of secretory immunoglobulin A (IgA), prostatic and periurethral glands secretions (Teodosio et al., 1999). The vagina is colonized by lactobacilli which maintain high acid environment and produces hydrogen peroxide that eliminates bacteria and reduces the ability of E. coli to adhere to the vaginal cells. The female urinary tract also produces a natural antibiotic called human beta- defensin 1 (HBD-1) which fights E. coli within the female urinary tract (Teodosio et al., 1999). It is when these processes fail that UTI develops (Teodosio et al., 1999). UTI may be expressed at a single site- urethra- urethritis, bladder- cystitis. This the most common form of UTI. Pyelonephritis - infection of the kidney. UTI could be asymptomatic when the patient lacks symptoms such as pain when you want to urinate, urgency, fever, heaviness in the lower abdomen suggestive of UTI (Lucas and Cunighan, 1993) or symptomatic. Asymptomatic UTI is common in pregnancy (Robert and Edward, 1999). Complicated UTI occur at a site other than the bladder and are nosocomial in origin (Mikenzie et al., 1994). An estimated 40% of women report having had a UTI some point in their lives Kunin, (1994). Pregnant women are at increased risk of developing UTI. Begining in week 6 and peaking during week 22 to 26 approximately 19% of pregnant women develop urethral dilatation and 70% develop glycosuria, increase in urinary progestin and estrogen. All these lead to decrease ability of the lower urinary tract to resist invading bacteria (Sobel et al., 1997). In USA, the prevalent rate of UTI in pregnancy was found to be 2-4% (National Kidney and Urologic Disease Centre, USA 2003). Oslen, et al; (2000) found a prevalent rate of UTI in rural Tanzania 16.4% while in Jos, Nigeria Nnatu, et al; (1989) in their study got 8% prevalent rate of UTI. The organisms that cause UTI in pregnancy are the same as in non- pregnant women with E. coli being the predominant 80-90% (Mikenzie et al., 1994). Untreated UTI in pregnancy may lead to the development of pyelonephritis in up to 50% of the cases, increased rate of prematurity, miscarriage, low birth weight, mental retardation, fetal death, maternal anaemia and end point renal failure (Robert and Edward, 1999). It is widely recognized that many problems could be prevented by the application of knowledge available. However, many practical issues are yet to be addressed; When should urine culture be obtained in pregnancy?, What diagnostic threshold should be used to define infection?, what are the drugs of choice for UTI bearing in mind the re- emerging multi-drug resistant of initial therapy of choice for UTI. This study attempts to clarify these issues in Anambra State, Nigeria. MATERIALS AND METHODS A random study was done among pregnant women attending antenatal clinics at General hospitals Onitsha and