Epidemiological characteristics of asymptomatic bacteriuria in pregnancy: prevalence, etiology, and antibiotic resistance (A literature review)
DOI:
https://doi.org/10.37800/RM.3.2026.867Keywords:
asymptomatic bacteriuria, pregnancy, prevalence, etiology, antibiotic resistance, epidemiology, screeningAbstract
Relevance: Asymptomatic bacteriuria is among the most commonly recorded urinary tract infections in obstetric practice. Undetected and untreated, it increases the likelihood of acute pyelonephritis, preterm birth, low birth weight, and other adverse perinatal outcomes.
The study aimed to analyze the epidemiological characteristics of asymptomatic bacteriuria in pregnancy, specifically its prevalence, etiological structure, and antibiotic resistance patterns.
Materials and Methods: We searched PubMed, Scopus, Web of Science, and Google Scholar for publications in Kazakh, Russian, and English. We included observational studies, systematic reviews, meta-analyses, and guidelines reporting the prevalence, etiology, or antimicrobial susceptibility of asymptomatic bacteriuria in pregnancy, and synthesized the findings narratively. We included 41 publications from January 2016 to May 2026 and extracted each report’s diagnostic criterion alongside prevalence data.
Results: Reported prevalence varied widely between countries, from 2% to 74.1%. Kazakhstani studies reported 12.2% to 26%, and studies from other CIS countries reported 7.6% to 19%. None of the included prevalence reports described a confirmatory second culture, which limits comparability. Escherichia coli was the leading pathogen in most series, accounting for 33.4% to 53.8% of isolates, followed by Klebsiella pneumoniae, Staphylococcus aureus, Enterococcus spp., and Proteus mirabilis. Resistance to ampicillin and co-trimoxazole was high, reaching 100% among Gram-negative isolates in one Ethiopian series, and multidrug resistance was reported in 23.65% of isolates in an Indian cohort.
Conclusion: Asymptomatic bacteriuria remains common in pregnancy, and the resistance profiles reported over the past decade complicate the choice of empirical treatment. The evidence supports one urine culture at the first antenatal visit, five to seven days of susceptibility-guided treatment, and annual regional reporting of susceptibility data. Low-certainty evidence indicates that treatment reduces the incidence of pyelonephritis by approximately three-quarters. Kazakhstan needs multicentre epidemiological research.
References
1. Сатыбалдин Д.А., Кравченко Е.Н., Вотрина И.Р. Бессимптомная бактериурия беременных, опыт лечения в БУЗОО ГКПЦ г. Омска. Мать и дитя в Кузбассе. 2018;1(72):11-13.
Satybaldin DA, Kravchenko EN, Votrina IR. Asymptomatic bacteriuria in pregnant women: treatment experience at the Omsk Clinical Perinatal Centre. Mat’ i ditya v Kuzbasse = Mother and Baby in Kuzbass. 2018;1(72):11-13. Russian.
2. Набока Ю.Л., Рымашевский А.Н., Коган О.М., Гудима И.А., Воробьева Н.В., Алкина А.К.. Бессимптомная бактериурия и пиелонефрит при беременности. Медицинский вестник Юга России. 2021;12(3):22-31.
Naboka YL, Rymashevsky AN, Kogan OM, Gudima IA, Vorobyeva NV, Alkina AK. Asymptomatic bacteriuria and pyelonephritis during pregnancy. Meditsinskiy vestnik Yuga Rossii = Medical Herald of the South of Russia. 2021;12(3):22-31. Russian.
https://doi.org/10.21886/2219-8075-2021-12-3-22-31
3. Борзенкова ЕА, Коханова ДА, Жиляева ДВ, Мамина ЮР, Московская ЛВ. Бессимптомная бактериурия и ее влияние на течение беременности и родов. В: Сикорский АВ, Хрыщанович ВЯ, ред. Актуальные проблемы современной медицины и фармации – 2019: сборник тезисов докладов LXXIII Международной научно-практической конференции студентов и молодых ученых. Минск: БГМУ; 2019. С. 13.
Borzenkova EA, Kokhanova DA, Zhilyaeva DV, Mamina YuR, Moskovskaya LV. Asymptomatic bacteriuria and its impact on the course of pregnancy and childbirth. In: Sikorski AV, Khryshchanovich VYa, editors. Current Problems of Modern Medicine and Pharmacy – 2019: Proceedings of the 73rd International Scientific and Practical Conference of Students and Young Scientists. Minsk: Belarusian State Medical University; 2019. p. 13. Russian.
4. Ситдикова Д.Г., Фаткуллина И.Б., Галиуллина Л.А. Акушерские и перинатальные аспекты бессимптомной бактериурии у несовершеннолетних беременных. Архив акушерства и гинекологии им. В.Ф. Снегирёва. 2023;10(1):67-71.
Sitdikova DG, Fatkullina IB, Galiullina LA. Obstetric and perinatal aspects of asymptomatic bacteriuria in underage pregnant women. Arkhiv akusherstva i ginekologii im. V.F. Snegirova = V.F. Snegirev Archives of Obstetrics and Gynecology. 2023;10(1):67-71. Russian.
https://doi.org/10.17816/2313-8726-2023-10-1-67-71
5. Сухорукова А.О., Степанькова Е.А., Покусаева В.Н., Лямец Л.Л. Диагностика бессимптомной бактериурии у беременных: рациональные подходы. Врач. 2023;34(9):43-46.
Sukhorukova AO, Stepankova EA, Pokusaeva VN, Lyamets LL. Diagnosis of asymptomatic bacteriuria in pregnant women: rational approaches. Vrach = Doctor. 2023;34(9):43-46. Russian.
https://doi.org/10.29296/25877305-2023-09-09
6. Дегтярева Е.И., Романова Д.Г. Инфекции мочевыводящих путей у беременных. Медицинский совет. 2024;18(4):65-72.
Degtyareva EI, Romanova DG. Urinary tract infections in pregnant women. Meditsinskiy sovet = Medical Council. 2024;18(4):65-72. Russian.
https://doi.org/10.21518/ms2024-158
7. Luu T, Albarillo FS. Asymptomatic bacteriuria: prevalence, diagnosis, management, and current antimicrobial stewardship implementations. Am J Med. 2022;135(8):e236-e244.
https://doi.org/10.1016/j.amjmed.2022.03.015
8. Nicolle LE, Gupta K, Bradley SF, Colgan R, DeMuri GP, Drekonja D, et al. Clinical practice guideline for the management of asymptomatic bacteriuria: 2019 update by the Infectious Diseases Society of America. Clin Infect Dis. 2019;68(10):e83-e110.
https://doi.org/10.1093/cid/ciy1121
9. American College of Obstetricians and Gynecologists. Urinary tract infections in pregnant individuals [Internet]. www.acog.org. 2023 [cited 2026 Aug 23]. Available from:
10. Moore A, Doull M, Grad R, Groulx S, Pottie K, Tonelli M, Courage S, Garcia AJ, Thombs BD; Canadian Task Force on Preventive Health Care. Recommendations on screening for asymptomatic bacteriuria in pregnancy. CMAJ. 2018;190(27):E823-E830.
https://doi.org/10.1503/cmaj.171325
11. Cotton E, Geraghty R, Umranikar S, Saeed K, Somani B. Prevalence of asymptomatic bacteriuria among pregnant women and changes in antibiotic resistance: a 6-year retrospective study. J Clin Urol. 2022;17(1):9-15.
https://doi.org/10.1177/20514158221095672
12. Khapre M, Sharma D, Mehta A, Sinha S. Prevalence of asymptomatic bacteriuria (ASB) in pregnant women in India: a systematic review and meta-analysis. Indian J Community Med. 2023;48(6):879-887.
https://doi.org/10.4103/ijcm.ijcm_795_22
13. Fowora MA, Osuolale KA, Ogunsanya J, Onyeaghasiri FU, Edu-Muyideen IO, Akintunde G, Iwalokun B. Prevalence and risk factors of asymptomatic bacteriuria among apparently healthy women in Lagos, Nigeria. World J Public Health. 2021;6(4):204-208.
https://doi.org/10.11648/j.wjph.20210604.20
14. Kalinderi K, Delkos D, Kalinderis M, Athanasiadis A, Kalogiannidis I. Urinary tract infection during pregnancy: current concepts on a common multifaceted problem. J Obstet Gynaecol. 2018;38(4):448-453.
https://doi.org/10.1080/01443615.2017.1370579
15. World Health Organization. Antimicrobial resistance [Internet]. World Health Organization. 2023 [cited 2026 Aug 23]. Available from:
https://www.who.int/news-room/fact-sheets/detail/antimicrobial-resistance
16. Dusmagambetova AM, Dusmagambetov MU, Zhunusov DK, Zhusupov BZ. Microbial landscape and antibiotic resistance of the main causative agents of asymptomatic bacteriuria of pregnant women for the period 2013-2016. In: Science and Innovations 2021: Development Directions and Priorities. Part 2: Proceedings of the International Scientific Conference. Melbourne: AUS Publishers; 2021. p. 162-169.
https://doi.org/10.34660/INF.2021.42.15.026
17. Сон В.Н., Рысулы М.Р., Тұрсыналиев С.Т., Рамазанов М.Е. Микробиологический скрининг и определение антибиотикорезистентности уропатогена Escherichia coli у беременных женщин в поликлинике ГКБ №7 г. Алматы. Вестник Казахского национального медицинского университета. 2021;(3):75-80.
Son VN, Rysuly MR, Tursynaliev ST, Ramazanov ME. Microbiological screening and determination of antibiotic resistance of the uropathogen Escherichia coli in pregnant women at the outpatient clinic of Almaty City Clinical Hospital No. 7. Vestnik Kazakhskogo natsional’nogo meditsinskogo universiteta = Bulletin of the Kazakh National Medical University. 2021;(3):75-80. Russian.
18. Зефирова Т.П., Железова М.Е., Ахметшина И.И. Спорные вопросы диагностики и лечения бессимптомной бактериурии у беременных женщин. Prakticheskaya meditsina = Практическая медицина. 2018;16(6):34-38.
Zefirova TP, Zhelezova ME, Akhmetshina II. Disputable issues of diagnosing and treatment of asymptomatic bacteriuria in pregnant women. Practical Medicine. 2018;16(6):34-38. Russian.
https://doi.org/10.32000/2072-1757-2018-16-6-34-38
19. Головко Т.В., Лацинська С.А., Дикленко Т.В., Останіна Т.Г., Воронкова О.С. Видове різноманіття мікроорганізмів, що виділяються при бактеріуріях вагітних та з навколоплідних вод. Вісник проблем біології і медицини. 2021;4(162):243-246.
Holovko TV, Latsynska SA, Dyklenko TV, Ostanina TH, Voronkova OS. Specific diversity of microorganisms isolated during bacteriuria of pregnant women and from amniotic fluid. Visnyk problem biolohiyi i medytsyny = Bulletin of Problems in Biology and Medicine. 2021;4(162):243-246. Ukrainian.
https://doi.org/10.29254/2077-4214-2021-4-162-243-246
20. Bekbaulieva GN, Rasuljonova ZZ. Assessment of the effectiveness of complex therapy for asymptomatic bacteriuria in reducing gestational complications. Int J Med Sci Clin Res. 2026;6(3):27-29.
https://doi.org/10.37547/ijmscr/Volume06Issue03-06
21. Aladova LY, Khudayberdiyeva R, Rayimova F. Urinary tract infections during pregnancy: a scientific review based on population data from Uzbekistan and international approaches to diagnosis and treatment. Shokh Articles Library. 2026;6(2):958-964.
https://worldsiencepub.com/index.php/shokhal/article/view/8751
22. Onemu SO, Ige RF, Onemu-Metitiri MO, Uyigue PO, Obeagu EI. The prevalence of asymptomatic bacteriuria in pregnant women in Akure, Ondo State, Nigeria. DYSONA Life Sci. 2024;5(1):1-8.
https://doi.org/10.30493/dls.2023.151009
23. Ghafari M, Baigi V, Cheraghi Z, Doosti-Irani A. The prevalence of asymptomatic bacteriuria in Iranian pregnant women: a systematic review and meta-analysis. PLoS One. 2016;11(6):e0158031.
https://doi.org/10.1371/journal.pone.0158031
24. Azami M, Jaafari Z, Masoumi M, Shohani M, Badfar G, Mahmudi L, Abbasalizadeh S. The etiology and prevalence of urinary tract infection and asymptomatic bacteriuria in pregnant women in Iran: a systematic review and meta-analysis. BMC Urol. 2019;19:43.
https://doi.org/10.1186/s12894-019-0454-8
25. Sheppard M, Ibiebele I, Nippita T, Morris J. Asymptomatic bacteriuria in pregnancy. Aust N Z J Obstet Gynaecol. 2023;63(5):696-701.
https://doi.org/10.1111/ajo.13693
26. Amala SE, Karibi-Botoye R, Nwokah EG, Pius MT. Prevalence of asymptomatic bacteriuria in pregnancy and urinary tract infection in non-pregnant symptomatic women. Am J Biomed Sci. 2021;13(4):172-183.
https://doi.org/10.5099/aj210400172
27. Bizuwork K, Alemayehu H, Medhin G, Amogne W, Eguale T. Asymptomatic bacteriuria among pregnant women in Addis Ababa, Ethiopia: prevalence, causal agents, and their antimicrobial susceptibility. Int J Microbiol. 2021;2021:8418043.
https://doi.org/10.1155/2021/8418043
28. Patnaik M, Panigrahi K, Das B, Pathi B, Poddar N, Lenka PR, Pattnaik D. Prevalence, risk factors and causative organisms of asymptomatic bacteriuria in pregnancy. Int J Adv Med. 2017;4(5):1348-1354.
https://doi.org/10.18203/2349-3933.ijam20174281
29. Izuchukwu KE, Oranu EO, Bassey G, Orazulike NC. Maternofetal outcome of asymptomatic bacteriuria among pregnant women in a Nigerian teaching hospital. Pan Afr Med J. 2017;27:69.
https://doi.org/10.11604/pamj.2017.27.69.10492
30. Agarwal A, Pandey S, Maheshwari U, Singh MP, Srivastava J, Bose S. Prevalence of asymptomatic bacteriuria and antimicrobial resistance profile among pregnant females in a tertiary care hospital. Indian J Community Med. 2021;46(3):469-473.
https://doi.org/10.4103/ijcm.IJCM_792_20
31. Totadhri M, Lakshmanan A, Saraswathy MP, Mane MS. Asymptomatic bacteriuria of pregnant women in a tertiary care centre. J Educ Health Promot. 2022;11(1):249.
https://doi.org/10.4103/jehp.jehp_1752_21
32. Abu D, Abula T, Zewdu T, Berhanu M, Sahilu T. Asymptomatic bacteriuria, antimicrobial susceptibility pattern and associated risk factors among pregnant women attending antenatal care in Assosa General Hospital, Western Ethiopia. BMC Microbiol. 2021;21:348.
https://doi.org/10.1186/s12866-021-02417-6
33. Awoke N, Tekalign T, Teshome M, Lolaso T, Dendir G, Obsa MS. Bacterial profile and asymptomatic bacteriuria among pregnant women in Africa: a systematic review and meta-analysis. EClinicalMedicine. 2021;37:100952.
https://doi.org/10.1016/j.eclinm.2021.100952
34. Nteziyaremye J, Iramiot SJ, Nekaka R, Musaba MW, Wandabwa J, Kisegerwa E, Kiondo P. Asymptomatic bacteriuria among pregnant women attending antenatal care at Mbale Hospital, Eastern Uganda. PLoS One. 2020;15(3):e0230523.
https://doi.org/10.1371/journal.pone.0230523
35. Yadav K, Prakash S. Prevalence of asymptomatic bacteriuria during pregnancy at a tertiary care hospital of Province No. 2, Nepal. Tribhuvan Univ J Microbiol. 2019;6(1):32-38.
https://doi.org/10.3126/tujm.v6i0.26576
36. Wabe YA, Reda DY, Abreham ET, Gobene DB, Ali MM. Prevalence of asymptomatic bacteriuria, associated factors and antimicrobial susceptibility profile of bacteria among pregnant women attending Saint Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia. Ther Clin Risk Manag. 2020;16:923-932.
https://doi.org/10.2147/TCRM.S267101
37. Smaill FM, Vazquez JC. Antibiotics for asymptomatic bacteriuria in pregnancy. Cochrane Database Syst Rev. 2019;(11):CD000490.
https://doi.org/10.1002/14651858.CD000490.pub4
38. Rafat D, Agrawal A, Khalid S, Khan AU, Nawab T, Sultan A. Bacterial abundance and antimicrobial resistance patterns of uropathogens among pregnant women with asymptomatic bacteriuria: association with glycemic status. Eur J Obstet Gynecol Reprod Biol X. 2024;21:100263.
https://doi.org/10.1016/j.eurox.2023.100263
39. Ayoyi AO, Kikuvi G, Bii C, Kariuki S. Prevalence, aetiology and antibiotic sensitivity profile of asymptomatic bacteriuria isolates from pregnant women in selected antenatal clinic from Nairobi, Kenya. Pan Afr Med J. 2017;26:41.
https://doi.org/10.11604/pamj.2017.26.41.10975
40. Tadesse S, Kahsay T, Adhanom G, Kahsu G, Legese H, G/Wahid A, Derbie A. Prevalence, antimicrobial susceptibility profile and predictors of asymptomatic bacteriuria among pregnant women in Adigrat General Hospital, Northern Ethiopia. BMC Res Notes. 2018;11:740.
https://doi.org/10.1186/s13104-018-3844-1
41. Odindo DA, Ochieng B, Onduru F, Ouma C, Onguru D, Awandu SS. Etiology of asymptomatic bacteriuria, antimicrobial susceptibility patterns and associated risk factors among pregnant women attending antenatal clinic in western Kenya. PLOS Glob Public Health. 2025;5(3):e0004347.
https://doi.org/10.1371/journal.pgph.0004347
42. Belete MA. Bacterial profile and ESBL screening of urinary tract infection among asymptomatic and symptomatic pregnant women attending antenatal care of Northeastern Ethiopia Region. Infect Drug Resist. 2020;13:2579-2592.
https://doi.org/10.2147/IDR.S258379
43. Widmer M, Lopez I, Gülmezoglu AM, Mignini L, Roganti A. Duration of treatment for asymptomatic bacteriuria during pregnancy. Cochrane Database Syst Rev. 2015;(11):CD000491.
https://doi.org/10.1002/14651858.CD000491.pub3
44. US Preventive Services Task Force. Screening for Asymptomatic Bacteriuria in Adults: US Preventive Services Task Force Recommendation Statement. JAMA. 2019;322(12):1188-1194.
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