Asymptomatic bacteriuria among pregnant women attending antenatal clinic at a tertiary care centre

Background: The term asymptomatic bacteriuria is defined as the presence of > 100,000 colonies of a single bacterial species per millilitre of urine (105 cfu /mL), cultured from clean catch midstream sample in the absence of declared symptoms. The aim of this study was to know the incidence of asymptomatic bacteriuria in pregnancy and the various factors influencing it, to identify the pathogens and their antibiotic susceptibility patterns.Methods: Clean catch mid-stream urine samples were collected from 3000 pregnant women (all trimesters) aged between 18-35 years of age attending the antenatal OPD in GMCH, Guwahati for a period of one year (July 2018-June2019).  Identification of organisms and antibiotic sensitivity tests were performed as per standard methods.Results: In our study, incidence of asymptomatic bacteriuria was found to be 12.1%. Most women (52.89%) were in the age group of (20-30) years, mostly in second trimester (47.1%). Gram negative organisms were the commonest organisms isolated; among which Escherichia coli (56.75%) was the principal urinary pathogen followed by Klebsiella sp (14.33%) and Staphylococcus saprophyticus (12.67%). The isolates were most sensitive to Nitrofurantoin (87.88%).Conclusions: Asymptomatic bacteriuria is common in pregnancy. Once ASB is recognized during pregnancy, it should be appropriately treated with antibiotics and promptly followed up

Gene plasticity in colonic circular smooth muscle cells underlies motility dysfunction in a model of postinfective IBS

The cellular mechanisms of motility dysfunction in postinfectious irritable bowel syndrome (PI-IBS) are not known. We used a rat model of neonatal inflammation to test the hypothesis that gene plasticity in colonic circular smooth muscle cells underlies motility dysfunction in PI-IBS. Mild/moderate or severe inflammation was induced in neonatal and adult rats. Experiments were performed in tissues obtained at 7 days (short term) and 6–8 wk (long term) after the induction of inflammation. Severe inflammation in neonatal rats induced persistent long-term smooth muscle hyperreactivity to acetylcholine (ACh), whereas that in adult rat caused smooth muscle hyporeactivity that showed partial recovery in the long term. Mild/moderate inflammation had no effect in neonatal rats, but it induced smooth muscle hyporeactivity to ACh in adult rats, which recovered fully in the long term. Smooth muscle hyperreactivity to ACh resulted in accelerated colonic transit and increase in defecation rate, whereas hyporeactivity had opposite effects. Smooth muscle hyperreactivity to ACh was associated with increase in transcription rate of key cell-signaling proteins of the excitation-contraction coupling α1C subunit of Cav1.2 (L-type) calcium channels, Gαq, and 20-kDa myosin light chain (MLC20), whereas hyporeactivity was associated with their suppression. Inflammation in adult rats induced classical inflammatory response, which was absent in neonatal rats. Severe neonatal inflammation enhanced plasma norepinephrine and muscularis propria vasoactive intestinal polypeptide in the long term. We conclude that severe, but not mild/moderate, inflammation in a state of immature or impaired stress and immune response systems alters the transcription rate of key cell-signaling proteins of excitation-contraction coupling in colonic circular smooth muscle cells to enhance their contractility and accelerate colonic transit and defecation rate