Asymptomatic Bacteriuria among Pregnant Women in Two Hospitals in Saudi Arabia: A Cross-Sectional Study

Asymptomatic bacteriuria (ASB) during pregnancy poses a significant risk of maternal and fetal complications if left undetected and untreated. Our objective is to determine the prevalence of ASB, identify the common bacterial pathogens and their antimicrobial susceptibility patterns, and evaluate the associated risk factors among pregnant women. A cross-sectional study was conducted involving 392 pregnant women. Participants were sampled systematically, and urine cultures were performed for bacterial identification and antibiotic susceptibility testing. Demographic and clinical data were collected. Statistical analyses included descriptive statistics and a multivariate logistic regression intended to identify the predictors of ASB. The overall prevalence of ASB was 9.7%. Escherichia coli was the predominant isolate (39%), followed by Klebsiella pneumoniae (18%). In vitro testing showed that cefuroxime was effective against the limited number of the E. coli (n = 4) and K. pneumoniae (n = 2) isolates tested. Imipenem, vancomycin, and amikacin showed the highest antibiotic sensitivity for all organisms (≥ 96%), while high resistance was observed against ampicillin (74.3%), erythromycin (91.7%), and oxacillin (97.6%). Multivariate analysis identified the first trimester of pregnancy, advanced maternal age, low hemoglobin levels, and high HbA1C levels as significant predictors of ASB. Routine first-trimester screening and culture-guided antibiotic therapy are critical in preventing complications. The identified antimicrobial resistance patterns underscore the critical need to monitor antibiotics, along with tailored treatment approaches in this group of patients.