The main findings of this study were: the prevalence of UTI among pregnant women was 14.0% - regardless to the women's age, parity and gestational age -and E. coli was the commonest isolated organism with multi resistance toward different antibiotics. The prevalence of UTI among these women is similar to the prevalence of UTI among pregnant women in the neighbor countries e.g. 14.6% and 11.6% in Tanzania and Ethiopia [3, 11].
Age, parity and gestational age were not associated with UTI in this study as well as in neighboring Tanzania . However, maternal age, parity and morbid obesity have been previously observed as risk factors for UTI among pregnant women [8, 15, 16]. Likewise in this study gestational age was not found as risk factor for UTI among these women. Recently, it has been reported that, UTI developed in third trimester . 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 .
Other factors like low socio-economic status, sexual activity, washing genitals precoitus, postcoitus, not voiding urine postcoitus and washing genitals from back to front have observed as risk factors for UTI during pregnancy [15, 18]. These factors have not been investigated in the current study; otherwise the results would have been changed. According to the traditions in central Sudan, it might have been difficult to enquire about washing genitalia and sexual activity; otherwise patients' co-operation would be lost. Interestingly high prevalence of urinary tract infection has been reported among Sudanese females with genital mutilation , which was widely practiced in Central Sudan .
In this study E. coli was the most common pathogen (77.7% of the Gram-negative isolates, 42.4% of all isolate). This goes with results that obtained in Tanzania where E. coli was 38% of the Gram-negative isolates and 25% of all isolate . Likewise, many authors have the same findings e.g. in Pakistan and India [8, 22]. In this study E. coli showed multidrug resistance mainly to amoxicillin, co-trimoxazole and nitrofurantoin. In Africa e.g. Tanzania, Kenya and Senegal it have been reported that, E. coli in urinary isolates have a high antimicrobial resistance pattern [3, 10, 23]. Likewise Gales et al and Williams et al have reported high resistance of E. coli towards different antimicrobials in Latin American and Costa Rica, respectively [24, 25]. Although, S. aureus was known for years as rare urinary isolate , recently it has been reported to be the most frequent pathogen among pregnant women in Nigeria . In this setting it was found the second most prevalent bacteria, this is in concert to the other previous observation .
In this study, 42.4% women who had positive isolate received an antibiotic in the index pregnancy. It has been shown that anti-microbial resistance to one drug does not always correlate to the consumption of the same drug or closely related drugs . Inappropriate antimicrobial use can lead to inadequate therapy and contribute to further drug resistance . The inappropriate use of antimicrobial in low income countries is perhaps due to the lack of adequate knowledge about drugs and non-availability or non-accessibility of guidelines for therapy  or to the availability of antimicrobials without prescription and perhaps it was prescribed by non-skilled practitioners .