Etiology, frequency and clinical outcomes related to Urinary Tract Infection and Asymptomatic Bacteriuria in pregnant women in a municipality of Southeast Brazil

Rebeca Lobato Alves,Gabriele Fernandes Bueno Ortiz,Ághata Cardoso Da Silva Ribeiro,Mariana De Freitas Augusto,Luciene Andrade Da Rocha Minarini

doi:10.33448/rsd-v11i3.26650

Rebeca Lobato Alves, Gabriele Fernandes Bueno Ortiz + Show 3 more

Open Access

https://doi.org/10.33448/rsd-v11i3.26650

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Abstract

Objective: The aim of this study was to investigate cases of Urinary tract infection (UTI) and Asymptomatic bacteriuria (ASB) in pregnant women in a Brazilian city, as well as identify the pathogens causing these diseases and its antimicrobial susceptibility profile. Also, we investigated the antibiotic therapy used in pregnant women to treat UTI and ASB, and the comorbidities which can be related to increased risk of these type of infection. Methods: This study was prospective research, descriptive and exploratory, with a qualitative approach, conducted among 35 pregnant women from October 2019 at Basic Health Unit (BHU) in Diadema, São Paulo, Brazil. Patient’s data were obtained using specific terms in the search filters from data base of BHU, as well the results of identification of bacterial species isolated from urine culture and the Antimicrobial Susceptibility Testing (AST). Results: From 35 study participants, 34.3% had a presumptive diagnosis of ASB and 65.7% had a diagnosis of symptomatic UTI. The predominant bacteria isolated were Escherichia coli (n=11) and Staphylococcus saprophyticus (n=2). The AST revealed a low rate of resistance to antimicrobials used for the treatment of UTI. The antimicrobial agents most prescribed was cephalexin. Further, 13 pregnant women presented comorbidities. Also, 20% presented premature delivery and 11,4% babies presented neonatal diseases. Conclusion: In this study, it was possible to know which bacterial species are commonly isolated from pregnant women urine cultures and evaluate the isolates susceptibility profile, as well as analyze the common antimicrobial therapy prescribed to these women.

Highlights

Urinary tract infection (UTI) is the most common bacterial infectious disease that usually affects the lower urinary tract, which is composed by the bladder, ureters and urethra inducing cystitis, ureteritis and urethritis, respectively (Schnarr et al, 2008)
Thirty-five pregnant women over 18 years old and with medical records with presumptive information about UTI and/or at least one positive result of prenatal urine culture were included in the study
The diagnosis results showed that 34.3% (12/35) had a presumptive diagnosis of asymptomatic bacteriuria (ASB) and 65.7% (23/35) had a diagnosis of symptomatic UTI

Summary

Introduction

Urinary tract infection (UTI) is the most common bacterial infectious disease that usually affects the lower urinary tract, which is composed by the bladder, ureters and urethra inducing cystitis, ureteritis and urethritis, respectively (Schnarr et al, 2008). Lower UTI is classified as uncomplicated, but if left untreated can affect the kidneys, causing pyelonephritis and other complications (Kalinderi et al, 2018). Women are more susceptible to developing UTIs due to their anatomical characteristics, such as the short urethra and its proximity to the anus, which facilitates invasion and colonization of the urethra by bacteria, especially the Enterobacterales, such as Escherichia coli (Gyftopoulos et al, 2019). Due to physiological and anatomical changes that favors the development of UTI (Glaser et al, 2015), this infection ends up being the most frequent within this group and the second most common complication in gestational periods (Amiri et al, 2015; Szweda et al, 2016)

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