Klebsiella Pneumoniae among pregnant women attending antenatal care at Entebbe regional referral hospital in Wakiso district, A cross-sectional study.

Abstract

Background:

 Klebsiella pneumoniae (K. Pneumoniae) accounts for nearly one-third of gram-negative bacterial infections in hospitals, and pregnant women are at a higher risk. Structural and physiological changes in the urinary tract facilitate bacterial movement into the bladder. This study aimed at determining the prevalence of K. Pneumoniae among pregnant women attending antenatal care at Entebbe Regional Referral Hospital in Wakiso district.

 Methodology:

 A hospital-based cross-sectional design was used among 120 pregnant women attending ANC at Entebbe Regional Referral Hospital from August 2025 to November 2025. Data was collected using a structured questionnaire. Prevalence of K. Pneumoniae and its microbial sensitivity was determined by urine culture and sensitivity.

 Results:

Overall, 41.7% were aged 16-25 years, 26-35 years, 36.7%, 36-45 years, 21.6%. Of the 57 mothers, 47.5% were single, 42.5% married, and 10.0% were divorced. In addition, 21.6% of pregnant mothers had no formal education, 27.5% primary, 25.8% secondary level, and 25.0% tertiary level. 45.0% mothers were in the second trimester, 34% in the third trimester, and 20.8% in the first trimester. The prevalence of K. Pneumoniae was 10.5% from 47.5% of UTI urine samples. K. Pneumoniae isolates were 100% sensitive to Amoxicillin-Clavulanic acid and Meropenem, moderately sensitive to Nitrofurantoin (66.7%), but showed high resistance to Levofloxacin and Ciprofloxacin (66.7%), as well as Ceftriaxone and Gentamicin (50.0%). Younger maternal age (16–25 years, 50.0%), secondary level of education (66.7%), third trimester of pregnancy (50.0%), and history of recurrent UTIs (83.3%) were identified as risk factors associated with K. Pneumoniae infection among pregnant women.

 Conclusion:

 Growing concern of antimicrobial resistance among uropathogens in pregnancy, underscoring the importance of targeted screening and preventive strategies among high-risk groups to reduce maternal morbidity and adverse pregnancy outcomes.

 Recommendation:

Urine culture and sensitivity should be incorporated into the routine screening of UTIs for pregnant women during antenatal care.