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CORRESPONDENCE
Year : 2015  |  Volume : 33  |  Issue : 1  |  Page : 177-178
 

Hygiene practices and sexual activity associated with urinary tract infection in rural pregnant women of Nagpur, India


Department of Community Medicine, Indira Gandhi Government Medical College, Nagpur, Maharashtra, India

Date of Submission30-Sep-2013
Date of Acceptance11-Mar-2014
Date of Web Publication5-Jan-2015

Correspondence Address:
S S Thakre
Department of Community Medicine, Indira Gandhi Government Medical College, Nagpur, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0255-0857.148416

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How to cite this article:
Thakre S S, Dhakne S N, Thakre S B, Ughade S N. Hygiene practices and sexual activity associated with urinary tract infection in rural pregnant women of Nagpur, India. Indian J Med Microbiol 2015;33:177-8

How to cite this URL:
Thakre S S, Dhakne S N, Thakre S B, Ughade S N. Hygiene practices and sexual activity associated with urinary tract infection in rural pregnant women of Nagpur, India. Indian J Med Microbiol [serial online] 2015 [cited 2019 Nov 15];33:177-8. Available from: http://www.ijmm.org/text.asp?2015/33/1/177/148416


Dear Editor,

Urinary tract infection (UTI) is a common problem in pregnancy. The prevalence of UTI in India was reported to be 3.14-19.87%. [1],[2] UTI is associated with obstetric factors like parity and past history of abortion. [2] Other factors like sexual behaviour, water intake and urination habits are also contributing factors for UTI. [3],[4] This study was planned to estimate prevalence of UTI, and to find out association of obstetric factors, urinary habits, sexual practices and water intake with UTI in rural setting. The present cross-sectional study was conducted among the pregnant women who attended the Antenatal clinic of the Rural Health Training Centre of the Medical College, Nagpur, India. Three hundred pregnant women were enrolled by a systemic random sampling technique from June 2009 to December 2009. The data which related to the study variables were sought through a personal interview technique.

The mean age (± SD) of the pregnant women was 23.17 (±2.91) years. In the present study, 29 urine culture samples were found to be positive for UTI, thus yielding an overall prevalence of 9.6% (95% CI 9.53-9.63%). Out of the 29 UTI subjects, 18 (62.06%) had  Escherichia More Details coli and Coagulase-negative Staphylococci 3 (10.34%), and the remaining had infections which were caused by Klebsiella 2 (6.90%), Enterococci 2 (6.90%), Proteus 1 (3.45%) and Candida albicans 1 (3.45%).

A number of genital hygiene practices were associated with UTI in univariate analyses.

Multigravida, water intake less than 1 litre per day, frequency of urination >6 times per day, frequency of sexual intercourse more than three times per week, post-coital washing and voiding were most associated variables with UTI in pregnancy [Table 1].
Table 1: Frequency distribution of UTI by maternal and sexual hygienic factors


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UTI was significantly higher in multigravidity (OR = 1.28; 95% CI: 0.573-2.855, P = 0.01) and not having history of abortion (OR = 4.07; 95% CI: 1.738- 9.554, P = 0.01). A significant difference was also observed in water intake ≤1 litre/day (OR = 3.84; 95% CI: 1.746-8.44, P = 0.01), no significant difference was found in variable such as Frequency of urination ≥6 times/day (OR = 5.76; 95% CI: 1.337-24.77, P = 0.01). Habit of postponing urination (OR = 4.16; 95%CI: 8.483-11.654, P = 0.01) was significantly associated with UTI. Sexual intercourse >3 times/week (OR = 2.34; 95% CI: 0.768-7.142) and not washing genitalia after coitus (OR = 1.67; 95% CI: 0.546-5.129) were associated with UTI but the difference was not significant. Not voiding after coitus was significantly associated (OR = 3.83; 95% CI: 1.58-9.328, P = 0.01). [1],[2]

The prevalence of UTI among the pregnant women in the present study was 9.67%. These findings corroborated well with those of other Indian studies. [1],[2],[3] In our study, we included only the urinary symptoms to define the symptomatic bacteriuria. In the present study the commonest (62.06%) cause of UTI was E. coli and 100% sensitive to nitrofurantoin. [2],[3] In the present study proportion of primigravida was significantly more in UTI as compared to non-UTI subjects (P < 0.01). Perhaps the susceptibility of UTI during this period is due to uretral dilatation which started as early as 6 week and reaching the maximum during 22-24 weeks. [5] In this study, no previous history of abortion was significantly associated (OR = 4.07, P = 0.01) with the occurrence of UTI. Shirazi et al.,[6] found that 13.2% of women with asymptomatic bacteriuria had a past history of abortion as compared to 12.1% in non-bacteriuric women. Frequency of sexual intercourse ≥3 times/week was associated risk factor (OR = 2.34) with UTI but the difference was not significant. Amiri et al., (2000) [4] found that sexual intercourse ≥3 times per week (OR = 5.62), was important risk factor for UTI in pregnancy. Bandopadhya et al., [3] also noted that prevalence of bacteriuria was significantly high among those who had intercourse more frequently. Post-coital washing in last 30 days was low in 4 (6.7%) of UTI subjects and 56 (93.3%) in non-UTI subjects. However, this difference was found to be statistically non-significant (OR = 1.6, P = 0.36). [4]

This article summarizes, our investigation found that UTI in our sample of women were primarily caused by bacteria E. coli and that hygiene habits and sexual behaviour may play a role in UTI in pregnant women. Other habit like less consumption of water was associated with UTI in pregnant women. It is necessary to promote genital hygiene, adequate water intake and healthy sexual behaviour for prevention of UTI.


 ~ Acknowledgment Top


The development of ideas and the mode of their presentation in this work owe much to Dr. Archana Patel, M.D. Paediatrics, Professor and Head, IGGMC, Nagpur, India from whom I have learned and continue to learn a great deal. Her kin interest, constructive criticism and constant encouragement were the prime factors that made my task easy and enabled me to complete this work successfully.

 
 ~ References Top

1.
Sabhrawal ER. Antibiotics susceptibility patterns of uropathogens in obstetrics patients. N Am J Med Sci 2012;4:310-9. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3409656 [Last accessed on 25 Sept. 2013].  Back to cited text no. 1
    
2.
Lavanya SV, Jogalakshmi D. Asymptomatic bacteriuria in antenatal women. Indian J Med Microbiol 2002;20:105-6.  Back to cited text no. 2
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3.
Bandyopadhyay S, Thakur JS, Ray P, Kumar R. High prevalence of bacteriuria in pregnancy and its screening methods in north India. J Indian Med Assoc 2005;103:259-62,266.  Back to cited text no. 3
    
4.
Amiri FN, Rooshan MH, Ahmady MH, Soliamani MJ. Hygiene practices and sexual activity associated with urinary tract infection in pregnant women. East Mediterr Health J 2009;15:104-10.  Back to cited text no. 4
    
5.
Delzell JE Jr, Lefevre ML. Urinary tract infections during pregnancy. Am Fam Physician 2000;61:713-21.  Back to cited text no. 5
    
6.
Shirazi MH, Sadeghifard N, Ranbar R, Daneshyar E, Ghasemi A. Incidence of asymptomatic bacteriuria during pregnancy. Pak J Biol Sci 2006;9:151-4.  Back to cited text no. 6
    



 
 
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