Antibiotics Susceptibility Patterns of Uropathogens Among Pregnant Women at Chukwuemeka Odumegwu Ojukwu University Teaching Hospital Awka, Nigeria

Abstract

Urinary tract infections (UTIs) are among the most prevalent bacterial infections affecting pregnant women and posing significant health risks and even death to both mother and fetus if not properly treated. The increasing incidence of antimicrobial resistance among uropathogens further complicates the effective management of UTIs in pregnant women. This research, investigated the antibiotic susceptibility patterns of uropathogens isolated among pregnant women at Chukwuemeka Odumegwu Ojukwu University Teaching Hospital (COOUTH) Awka,from March to May 2025.The inclusion criteria was:All pregnant women without current antibiotic therapy and who consented to participate during the time of study and pregnant women with one or more symptoms suggestive of UTI or asymptomatic women selected for routine screening.The exclusion criteria was:Pregnant women taking antibiotic treatment or have taken antibiotics within 7 days prior to urine sample collection or at the time of recruitment for any disease and that did not volunteer to participate in the study. And pregnant women diagnosed with other infections that might confound UTI diagnosis and influence susceptibility to infections and antibiotic response.Ethical approval for this study was obtained from the Research and Ethics Committee of Chukwuemeka Odumegwu Ojukwu University Teaching Hospital (COOUTH) Awka, Anambra State prior to the commencement of the research. A hospital-based cross-sectional study was conducted in which a total of one hundred and thirty-eight (138) midstream urine samples were collected aseptically from pregnant women and cultured using standard microbiological techniques. Identification of isolates was carried out using conventional biochemical methods, while antibiotics susceptibility testing was performed using Kirby-Bauer diffusion method. Out of the one hundred and thirty-eight (138) samples analyzed, hundred and ten (110), (79.7%) yielded significant bacterial detectable growth, while twenty-eight (28), (20.3%) showed no growth. The predominant isolate was Escherichia coli (40.9%), followed by Klebsiella species (22.7%), Staphylococcus aureus (13.6%), Proteus species (9.1%), Pseudomonas aeruginosa (7.3%) and Enterococcus faecalis (6.4%). Antibiotic susceptibility testing revealed high sensitivity to Ciprofloxacin (80%), gentamicin (75%) and nitrofurantoin (70%). Highest resistance levels were observed against amoxicillin (85%) and ampicillin (78%). The overall prevalence of multidrug resistance (MDR) among isolates was 62%, with Escherichia coli and Klebsiella species showing the highest resistance level. Statistical analysis using SPSS (Version 25.0) showed significant variation in antibiotic response among isolates (p < 0.05), though no significant association was found between demographic factors and antibiotic resistance (p > 0.05). The findings highlight Escherichia coli as the leading uropathogen among pregnant women. These findings indicate a high prevalence of antibiotic resistance among uropathogens in the study area, which may limit treatment options for UTIs in pregnancy. The study concludes that routine antibiotic susceptibility testing and rational antibiotic use are essential for the effective management of UTIs and for controlling the spread of resistant uropathogens among pregnant women at COOUTH, Awka, Nigeria.