Bacteriuria In Pregnant Women Research Articles

Asymptomatic bacteriuria in young pregnant women in modern society

The article provides an overview of the literature and existing international and national Guidelines on the etiology and main pathogens characteristics of asymptomatic bacteriuria, diagnostic criteria, management of young pregnant women with asymptomatic bacteriuria and antibacterial therapy regimens. Young pregnant women are a significant part of the society structure that requires protection. Young women in the age category of 1517 years are identified as a group with a high risk of complications during pregnancy, delivery and the postpartum period, as well as perinatal pathologies. Women of this age group are characterized by a high risk of complications: the threatened miscarriage, premature birth as well as young pregnancies usually accompanied by sexually transmitted infections. It is important for this group of patients to be more carefully monitored by doctors in the hospitals, maternity welfare centers, during delivery and postpartum period. The main causative agents of asymptomatic bacteriuria in pregnant women are representatives of the Enterobacteriaceae family (88.0%). E. coli, Klebsiella spp., Staphilococcus spp. cause asymptomatic bacteriuria only in 310% of cases. The diagnosis is based on the Russian Clinical Guidelines for Urology and the Federal Clinical Guidelines 2020, as well as on the European Guidelines of the Urologists Association 2020. The National Guidelines indicate the main principles of asymptomatic bacteriuria treatment in high risk patients (pregnant and young). Despite the progress made in the urinary tract infections study, especially asymptomatic bacteriuria in pregnant women, and the development of practical Guidelines for the management of these patients, this issue remains important in modern society.

Frequency of Asymptomatic Bacteriuria and its Causative Organisms among Pregnant Women Visiting for Antenatal Checkup in Outpatient Department of Sims/Services Hospital

Objective: The purpose of this study was to assess the frequency of asymptomatic bacteriuria and causative organisms that are responsible for the development of bacteriuria in pregnant women visiting antenatal checkup in outpatient Department in hospital. Methodology: This was a Cross sectional study conducted in the Outpatient department of Gynecology, SIMS/Services Hospital, Lahore after taking ethical approval. The duration of the study was about six months. Non-probability purposive sampling technique was used in the study. Any gestational age, all pregnant women with no clinical symptoms of bacteriuria were included in the study. Frequency and percentages was determined for qualitative data like asymptomatic bacteriuria and causative agent (i.e., Staph Aureus, E.coli, Klebsiella pneumonae). Results: A total of 220 pregnant women were selected. Their mean age were reported 26.12±4.08 years ranging from 17-37 years. Culture and sensitivity results confirmed 16(7.3%) cases with asymptomatic bacteriuria. Among 16 positive cases, E.coli was the predominant organism isolated in 8(50%) samples followed by Staphylococcus aureus in 4(25%) samples, Klebsiella in 1(6.25%), Candida Species in 1 (6.25%) and mixed growth in 2(12.5%) sample were detected in urine culture and sensitivity test. Conclusion: This study concludes that frequency of asymptomatic bacteriuria was uncommon amongst those pregnant women who attended for antenatal checkup. Most predominant pathogen isolated from culture was Escherichia coli followed by Staphylococcus aureus. Keywords: Bacteriuria, Escherichia coli, Staphylococcus aureus

Prevalence of Bacteriuria in Pregnant Women Visiting Provincial Hospital, Janakpurdham, Nepal

INTRODUCTION: Considering the importance of urinary tract infection (UTI) in pregnant women which is responsible for several complications, its diagnosis and treatment are essential to maintain the health of mother and baby.The purpose of the present study was to evaluate the isolation and identification of Escherichia coli from the UTI suspected pregnant women visiting at provincial Hospital Janakpur.
 MATERIALS AND METHODS: A total of 200 mid-stream urine samples were collected from UTI suspected pregnant women of 18 to 45 years visiting antenetal OPD in Provincial Hospital Janakpur in between February 2021 to April 2021. The collected urine samples were processed in the microbiology department of the Model Multiple College, Janakpur. Standard Microbiological procedures were followed.
 RESULTS: The Escherichia coli were predominant identified as 17 (35.41%). Patients aged between 25-30 years were mostly infected 35 (72.9%). The majority of bacteria isolated were more sensitive to Cephalexin and nitrofurantoin.
 CONCLUSIONS: Escherichia coli is one of the most important pathogen for UTI in pregnant women. The majority of bacteria isolated in the present study were more sensitive to Cephalexin and nitrofurantoin.

Comparative treatment scheme between nitrofurantoin and ampicillin in pregnant patients 12 to 16 weeks, gestation with asymptomatic bacteriuria

Urinary tract infection is a frequent cause of demand for care in family medicine, it can have a significant participation in maternal and neonatal morbidity. Objective. To compare the treatment scheme 7 with the antibiotic ampicillin in cases of asymptomatic bacteriuria in pregnant women with 12 to 16 weeks of gestation against nitrofurantoin. Material and methods. Observational, cross-sectional, retrospective and analytical study conducted in pregnant patients between weeks 12 and 16 of gestation with asymptomatic bacteriuria. Result. In patients with asymptomatic bacteriuria, a greater persistence of the infection was found when being treated with nitrofurantoin. Pregnant patients with 13 weeks had the highest incidence of asymptomatic bacteriuria with a frequency of 31.82 %. Conclusions. Nitrofurantoin may be considered a better treatment option than ampicillin, given its lower incidence rate of asymptomatic bacteriuria in pregnant patients at 12 to 16 weeks' gestation.

Incidence of Asymptomatic Bacteriuria in Pregnant Women

Background: Asymptomatic bacteriuria is the presence of bacteria in the properly collected urine of a patient that has no signs and symptoms of urinary tract infection.
 Aim: This study was carried out to determine the incidence of asymptomatic bacteriuria in pregnant women in Saveetha medical college, Thandalam, Tamil Nadu.
 Materials and Methods: A total of 250 pregnant women attending antenatal clinic at civil hospital, Saveetha medical college, over a period of 3 months, with age groups between 18 to 30 years agreed to enter the study and were clinically evaluated. All these women were asked to submit clean catch midstream urine samples and it was examined under the microscope and by culture method.
 Results: A total of 250 pregnant women included in our study, with varying age groups between 18 to 30 years and the highest incidence was seen in between the 26 to 30 age group. Asymptomatic bacteriuria was seen in 27.2% of the pregnant women. The prevalence of Escherichia coli was among the most dominant organism, followed by Staphylococcus aureus ,klebsiella and proteus species.
 Conclusion: The study showed 27.2% of the pregnant women to have asymptomatic bacteriuria. This can be reduced by screening the mothers in first trimester and routine urine culture test must be carried out.

Recurrent Urinary Tract Infections and Asymptomatic Bacteriuria in Adults.

Purpose of reviewOur goal was to summarize recent evidence regarding recurrent urinary tract infections and asymptomatic bacteriuria in different adult populations.Recent findingsSeveral research groups are focused on the description of resident bacterial flora in the bladder and urinary dysbiosis in the microbiome era. Even the definitions might change in light of these discoveries. However, the role of urinary microbiome and bacterial interference has still to be determined.SummarySystematic treatment of asymptomatic bacteriuria is not recommended and even classic indications such as asymptomatic bacteriuria in pregnant women are controversial. In fact, its treatment is associated with a higher probability of symptomatic UTI and a higher prevalence of antibiotic-resistant bacteria. Improving the diagnosis of asymptomatic bacteriuria and optimizing the management of recurrent urinary tract infections, especially through non-antibiotics measures, are needed in order to minimise antimicrobial resistance.

Role of routine urine culture in predicting asymptomatic bacteriuria in pregnancy and the prevalence of asymptomatic bacteriuria in pregnant women - Our experience

Asymptomatic bacteriuria (ASB) in pregnancy can flare into frank pyelonephritis and sepsis if untreated due to the low immunity. Apart from causing morbidity in mothers it affects the foetus by increasing the incidence of prematurity and IUGR. The present study was undertaken to determine the prevalence of ASB in the pregnant women attending Ante natal clinic and the significance of routine urine culture. : Total 310 pregnant women attending the antenatal OPD were enrolled in the study over a period of 10 months. Inclusion criteria included all pregnant women attending antenatal OPD without any urinary symptoms or history of fever. Exclusion criteria included frank UTI symptoms like fever, dysuria, increased frequency of urine, any history of intake of antibiotics, any urinary tract anomaly or renal calculi. Their midstream urine sampling was collected and subjected to both microscopy and culture sensitivity; standard microbiological method was used. The prevalence of ASB was found to be 11.29% and was maximum in second trimester (54.2%). The study revealed routine urine culture is a sensitive test to diagnose ASB. The commonest bacterium isolated was Escherichia coli (51.4% cases) and the most effective antibiotic was Nitrofurantoin. The neonatal outcomes are discussed in the text while no perinatal deaths were recorded during the period of study. No direct association of asymptomatic bacteriuria with anaemia and preeclampsia was found, but odds ratio was more than one. The study highlights that asymptomatic bacteriuria is a common occurrence in pregnant women, including urine culture as a part of routine investigation in antenatal patients can help diagnose this condition. Prompt treatment of ASB can prevent any obstetric complication arising from the flareup of asymptomatic bacteriuria in pregnancy and thus reduce maternal and foetal morbidity.

Prevalence and evaluation of asymptomatic bacteriuria in pregnant women

Introduction: Asymptomatic bacteriuria (ASB) is defined as the isolation of bacterial strain in quantitative counts ≥105cfu/mL in the urine without the presence of any symptoms. The aim of this study was to investigate prevalence and pathogen microorganisms of ASB, and the most appropriate diagnostic test in the fırst trimester of pregnancy. Methods: In this study, 312 pregnant women were included. Midstream culture by conventional methods and urinalysis were done. By considering the urine culture as the gold standard, sensitivity, specificity, positive predictive value and negative predictive value of bacteriuria and pyuria were calculated. Results: ASB prevalence was found at 6.7%. Specificity and sensitivity for bacteriuria were 77% and 100%. Specificity and sensitivity for pyuria was 65% and 61%. The common pathojens was E.coli (85.7%). Conclusion: Pyuria and bacteriuria may not a major determinant of the ASB but may be useful as a screening test.

Frequency of Asymptomatic Bacteriuria in Pregnant Women

Objectives: To determine the frequency of asymptomatic bacteriuria in pregnantwomen. Study design: Descriptive, Cross sectional study Place and Duration: Department of Obstetrics & Gynaecology, Benazir Bhutto Hospital, Rawalpindi. 26th December 2017 to 25th June 2018 Materials & Methods: A total of 151 pregnant women of gestational age ≥28 weeks, 18 to 40 years of age were included. Patients with genital tract trauma, history of UTI in the past one year and urinary tract stones were excluded. Then clean-catch midstream urine was collected from each woman into a sterile universal container and sample was sent to the institutional laboratory for presenceor absence of asymptomatic bacteriuria. Results: Age range in this study was from 18 to 40 years with mean age of 28.78 ± 3.90 years. Majority of the patients 84 (55.63%) were between 18 to 30 years of age. Mean gestational age was 31.06 ± 1.67 weeks. Mean parity was 3.17 ± 0.99. Mean BMI was 27.44 ± 3.02 kg/m2. In our study, frequency of asymptomatic bacteriuria in pregnant women was found in 25 (16.56%) patients. Conclusion: This study concluded that frequency of asymptomatic bacteriuria in pregnant women is quite high. Keywords: Asymptomatic Bacteriuria, Pregnancy, Urinary Tract Infection.

Aframomum melegueta [Roscoe] K. Schum) Ethanolic Seed Extract against Asymptomatic Bacteriuria Isolates from Pregnant Women Attending Antenatal Clinic in Ondo State, Nigeria

The purpose of this research work is to compare the activity of medicinal plant(Aframomum melegueta) and conventional antibiotic against Asymptomatic Bacteriuria isolates from pregnant women attending ante-natal clinic in a major primary health center in Akoko, south ,Ondo state Nigeria. The target Asymptomatic Bacteriuria isolates which is inherent in pregnant women with no observable features. The rate of growth/ death of Asymptomatic Bacteriuria Isolates were x-rayed. Bacteria were isolated from Urine of pregnant women attending antenatal clinic in Public health care Akungba Akoko, Ondo state, Nigeria and were identified using conventional method. The antibiotic susceptibility test and antimicrobial screening of ethanol seed extract of Aframomum melegueta were determined using disc diffusion and agar well diffusion methods respectively. The eleven(11) bacteria identified were Klebsiella pneumoniae (three,3), Proteus mirabilis, Proteus vulgaris, Bacillus subtilis(Two,2),Pseudomonas aeruginosa, Enterobacter cloacae (Two,2), Escherichia coli (three,3), Bacillus cereus, Serratia mercesiens, Enterobacter aerogens. E. coli and klebsiella pneumoniae were the most common isolates. The second most common isotales was Enterobacter cloacae.. Klebsiella pneumonia and Proteus mirabilis were resistant to Ampicillin, Ceporex, Nalixadic acid and Septrin. E. coli, the most common isolate was sensitive to Gentamycin and most of the antibiotics used. The antimicrobial screening of ethanol seed extract of Aframomum melegueta shows zones of inhibition with diameter ranging from 1-25mm. Secondary metabolite screening indicates the presence of flavonoid, tannins, saponins, alkaloids, cardiac glycosides. Ultraviolet spectrophotometer was also used to determine the Growth dynamic /Death rate of the isolates, the addition of antibiotics to the organism at the 48th hour speed up the death rate of the isolates, the addition of ethanol seed extract at the 48th hour also speed up the death rate of the isolates from the urine samples. The results of this study validate the use of Aframomum melegueta seed in the traditional treatment of Asymptomatic bacteriuria in pregnant women.

Asymptomatic Bacteriuria in pregnant women attending a tertiary hospital in northern India: prevalence, risk factors, causative organisms and antimicrobial sensitivity pattern

Background: Asymptomatic bacteriuria is common and can lead to adverse foetal and maternal outcomes.
 Aims and Objective: The current study aimed to estimate the prevalence of asymptomatic bacteriuria (ABU), its associated risk factors, bacterial isolates and antimicrobial sensitivity pattern in pregnant women attending Outpatient department (services in a tertiary hospital in India.
 Materials and Methods: This was a hospital-based cross-sectional study among asymptomatic women coming for routine antenatal check-ups to obstetrics OPD of a teaching hospital in Northern India. Samples were collected, processed and antimicrobial sensitivity done as per Clinical and Laboratory Standards Institute (CLSI) guidelines. Data was analysed and p value below 0.05 was considered as statistically significant.
 Results: Overall 247 pregnant women were included in the study with a mean age of 25.9 ± 3.1. The overall prevalence of asymptomatic bacteriuria was 18.6%. The most common isolates responsible for ABU were E. Coli (48%), S Aureus (23%), K. pneumonia (12%), Pseudomonas (6%), Enterococcus (6%), Proteus (5%). Gram-negative isolates were mostly sensitive to Fosfomycin, Meropenem, Piperacillin + Tazobactum whereas gram-positive isolates were usually sensitive to Fosfomycin, Vancomycin and Linezolid Most isolates were resistant to Co-amoxiclav, Ciprofloxacin, and Nitrofurantoin.
 Conclusion: Considering the high prevalence of ABU and its association with adverse maternal and foetal outcomes, urine culture should be included in routine investigations being offered to pregnant women. Gram-negative bacteria were the primary causative agents with Fosfomycin, Meropenem and Ceftazidime showing high level of efficacy against the pathogens.

A comparative study of various screening tests of Asymptomatic Bacteriuria in pregnant women attending Antenatal Outpatient Department’

Introduction: Urinary tract infections are the most common bacterial infections in pregnancy.Asymptomatic bacteriuria (ASB) refers to the presence of bacteria in the urine of an individualwithout symptoms of urinary tract infection. ASB which occurs in 2-11% of pregnancies is a majorpredisposition to the development of pyelonephritis. Aims and objectives: The aims and objectivesof the study were to: Study the effectiveness of various screening tests: urine microscopy, gramstain, catalase test, leukocyte esterase test and nitrite test and to compare their sensitivity,specificity, positive predictive value and negative predictive value. Materials and Methods: Thestudy included 500 pregnant women attending the outpatient department over 18 months. The urinesamples collected in sterile containers were screened for urine microscopy, gram stain, catalase test,leukocyte esterase test and nitrite test. The samples were processed on CLED (Cysteine lactoseelectrolyte deficient) agar as the standard against which other screening tests are identified.Results: Gram’s stain (89.34%) was the most sensitive of all and the least reliable test was thecatalase test among the methods of screening tests. Conclusion: Urine culture is considered to bethe gold standard in detecting ASB in pregnant women. Gram’s stain of urine is a good screeningtest when compared to other screening methods. Screening for bacteria in all trimesters isnecessary to prevent the dangerous complications associated with ASB.

Поліпшення ефективності лікування інфекції сечовивідних шляхів у вагітних

The aim is to evaluate the effectiveness of Phytolysin Active prescription in therapy of urinary tract infections in pregnant women. Materials and methods. The efficacy of Phytolysin Active (1 capsule per day for 21 days) in the complex treatment for urinary tract infection was studied in comparison with the group of pregnant women using traditional antimicrobial therapy. The first group consisted of 27 pregnant women who received complex treatment (antibiotic therapy + Phytolysin Active), the second consisted of 25 women who used exclusively antibiotic therapy. Among pregnant women in the first group, symptomatic gestational cystitis was observed in 9 (33.3%) cases, and in the second group in 8 (32%) patients. Results. The effectiveness of combination therapy with the use of Phytolysin Active was proved by significant improvement in general well-being and disappearance of cystitis symptoms in 8 (88.9%) women compared with 5 (62.5%) patients in the treatment group who used exclusively antimicrobial drugs. After treatment with the addition of Phytolysin Active to antibiotic therapy, Escherichiaсoli pathogen, which is most often diagnosed in this pathology, was observed in 1 (3.7%) women compared to 5 (20%) cases in the second group. Also, 25 (92.6%) women of the first group had no recurrence of urinary tract infections for 3 months. Conclusions. Complex treatment of asymptomatic bacteriuria in pregnant women with the use of the drug Phytolysin Active is more effective than the use of antibiotic therapy alone, which is proved by the high rate of the pathogen elimination and absence of infection recurrence for 3 months. The synergistic action of two active components of Phytolysin Active (Polpharma) – cranberry proanthocyanidins and lactobacillus acidophilus – improves the effectiveness of treatment and prevents relapse. The study was carried out in accordance with the principles of the Declaration of Helsinki. The study protocol was approved by the Local Ethics Committee of the institution. The informed consent of women was obtained for the research. The authors declare no conflicts of interest. Key words: pregnancy, urinary tract infections, treatments, herbal medicine, cranberry, lactobacilli.

Предварительные результаты проспективного сравнительного неинтервенционного исследования по лечению бессимптомной бактериурии у беременных

Introduction. Over the past three decades, the views on the diagnosis and treatment of asymptomatic bacteriuria in pregnant women have not undergone any changes. However, the majority of randomized clinical trials concerning the treatment of pathients with this nosology are of low methodological quality and date back to the 60-80s. Since then, diagnostic and treatment protocols have changed dramatically, so the quality of the evidence base is low. In a recent Scandinavian study of higher methodological quality, there was no clear benefit of antibiotic therapy in pregnant women with asymptomatic bacteriuria. Material and methods. This publication is devoted to the interim results of a study that analyzed the efficacy and safety of herbal medicinal product Canephron® N in the treatment of asymptomatic bacteriuria in 29 pregnant women aged 22 to 34 years at a gestation period of 14-28 weeks. When included in the study, as well as on days 14, 30 and 60, the following laboratory control was performed: general urine analysis, urine bacteriological examination, clinical analysis of vaginal smears, analysis of vaginal microbiota by quantitative PCR Results. In the group of our patients, the distributions by age and gestational age differed from normal, the mean values are presented by the median and were 29 years and 14 weeks, respectively. Already had children – 13 (44.8%) women. In total, 35 microorganisms were isolated in a diagnostically significant titer. Most of the representatives of the Enterococcaceae family were traditionally 57.1%. At the time of inclusion, the median pyuria was 2.5 μl and exceeded the reference values only in 10.3% of patients. Clinical examination of vaginal smears revealed no inflammatory changes. However, an assessment of the vaginal microbiota showed the presence of dysbiosis due to an increase in the amount of obligate-anaerobic microflora in 58.6% and vaginal candidiasis in 10.3% of pregnant women. After 2 months, the 28 pregnant women remaining in the study had no episodes of symptomatic urinary infection. During the herbal drug therapy, there was a decrease in diagnostically significant bacteriuria and signs of the inflammatory process in all patients. The frequency of vaginal dysbiosis was recorded in 10.7% of pregnant women (р>0,05). Conclusion. Thus, our preliminary results shows that the use of Canephron N in pregnant women with asymptomatic bacteriuria (ABU) may be an effective alternative approach comparing the use of antibiotics. The treatment with Canephron N promotes the normalization of the urinary tract microflora and save the intactness of the saprophytic flora, in contrast to antibacterial drugs, and this is especially important in the paradigm of the antibiotics stewardship and the fight against growing antibiotic resistance. Comparative results of the use of antibacterial agents and Canephron N will be analyzed in the next publication, on the basis of which final conclusions will be drawn about the advisability of using herbal medicines to control bacteriuria in pregnant women Conclusion. We have obtained encouraging results from the use of Canephron-N® in patients with asymptomatic bacteriuria in pregnant. To obtain an evidence base of a recommendatory level, it is advisable to increase the number of observations.

Antibiotics for culture-positive asymptomatic bacteriuria in pregnant women can prevent pyelonephritis.

Asymptomatic bacteriuria, occurring in 2-15% of pregnancies, is generally defined as at least one urine culture showing >100,000 colony-forming units (CFUs)/mL in the absence of fever or symptoms of urinary tract infection.1 Escherichia coli is the most commonly associated pathogen, comprising up to 80% of isolates.

Asymptomatic Bacteriuria in Pregnant Women: Frequency, Antimicrobial Susceptibility Profile, Causative Microorganisms and Risk Factors

Asymptomatic Bacteriuria in Pregnant Women: Frequency, Antimicrobial Susceptibility Profile, Causative Microorganisms and Risk Factors

Outpatient Antibiotic Prescriptions in Pregnant Women in Małopolska Province.

Background: excessive and incorrect use of antibiotics is a common event that contributes to increased bacterial resistance to antibiotics. Based on the European Centre for Disease Control and Prevention (ECDC) European Surveillance of Antimicrobial Consumption (ESAC)-Net reports, outpatient antibiotics prescribing in Poland, is higher than the European average rate. However, ECDC reports do not provide data on consumption in specific patient groups. Additional studies focused on selected patient groups are needed for a more detailed analysis. The use of antibiotics during pregnancy is inevitable due to the proven risk of complications in this period, perinatal infections, and infections in newborns, in the situation of frequent infections of the genital tract, urinary tract, and asymptomatic bacteriuria in pregnant women. The aim of this study was to analyze the use of antibiotics/the implementation of antibiotic prescriptions ordered by gynecologists during pregnancy in pregnant women in Małopolska Voivodeship, with particular emphasis on demographic data and drug groups. Material and methods: the analysis used data on the reimbursement of antibiotics from the Małopolska Health Fund for 2013–2014. The database contained information of a demographic nature: age, place of residence, date of birth, as well as information on the type of drug, and the number of packages purchased by the patients. Results: the study included 67,917 women. During pregnancy, 23.6% filled their prescriptions for antibiotics. In the first trimester, the percentage of women filling their prescriptions for antibiotics was the lowest and amounted to 7.8%, in the second and third trimesters, these were 9.0% and 11.2%, respectively. The inhabitants of rural areas bought antibiotics more often (23.5%). Most frequently, antibiotics were purchased by women under 18 years of age (32.1%), but the use of antibiotics in women aged 18–34 and over 35 was similar, amounting to 23.8% and 22.7%, respectively. Most often (94.78% of cases) monotherapy was used, including beta-lactams and beta-lactams with an inhibitor (67.3%), then second-generation cephalosporins (13.5%), macrolides (14.73%), and others. Prescription of two different preparations was found in 5.06% of cases, three (0.19%), and four or more (0.03%). Conclusions: due to the fact that studies on antibiotic therapy in pregnant women in Poland are rare, it is impossible to assess the situation thoroughly. Additionally, in Poland, the prevalence of gestational infections is unknown, and their diagnostics is important, especially in relation to microbiological diagnostics and targeted treatment. However, the present results indicate the need to implement broad health promotion programs, accessible to all women, also those living outside large cities, particularly promoting the prevention of urinary tract infections and reproductive health in general.

Опыт применения растительных препаратов в комплексном лечении неосложненных инфекций нижних мочевыводящих путей у беременных

Introduction During pregnancy, therapeutic options which can be used to treat and prevent acute lower urinary tract infections are significantly limited. In this regard, new opportunities to increase time to relapse of urinary tract infections are urgently required. Aim To evaluate the results of the use of the dietary supplements Cystenium II in pregnant women for the complex treatment of acute cystitis and asymptomatic bacteriuria. Materials and methods The analysis of complex therapy of uncomplicated lower urinary tract infection with the use of dietary supplements Cystenium II in 42 pregnant women (mean age 24.5+/-4.3 years), divided into two groups depending on the presence of symptoms of the cystitis. Results Data on the clinical and microbiological cure and the absence of side effects were obtained. Conclusions The use of dietary supplements Cystenium II is advisable, both in the complex antimicrobial therapy of acute cystitis, exacerbation of recurrent cystitis or asymptomatic bacteriuria in pregnant women, as well as for the prevention of recurrence of cystitis after the clinical cure.

P0962CHRONIC KIDNEY DESEASE AND URINARY TRACT INFECTION IN PREGNANTS

Abstract Background and Aims Pregnant women with chronic kidney disease (CKD) are at risk of developing/exacerbating urinary tract infection (UTI) due to the presence of additional (“specific”) risk factors. The aim of our study was estimation the features of UTI in women with CKD during pregnancy. Method The study included 139 women with CKD G1-G3 who had UTI during pregnancy. Most women (63) had chronic glomerulonephritis, 47 had with chronic pyelonephritis, and the rest had diabetic nephropathy (11), chronic tubulointerstitial nephritis (9), renal transplant (7) and lupus nephritis (2). An analysis of the bacteriological examination of urine, the sensitivity of pathogens to antibiotics, clinical manifestations and perinatal complications was performed. Results The following forms UTI are diagnosed: asymptomatic bacteriuria (50.4%), exacerbation of chronic pyelonephritis, including renal transplant (33.1%), acute pyelonephritis (16.5%). The true bacteriuria is determined identically at all stages of CKD, in those with chronic pyelonephritis in 70%, chronic glomerulonephritis in 45% of cases (p = 0.02). Gram-negative microorganisms become apparent in 73.6% of pregnant women with CKD, less often in patients with glomerular pathology than with chronic pyelonephritis (66% versus 81%). Escherichia coli among gram-negative microorganisms was 74.4%, a high frequency of detection of strains with the production of extended-spectrum β-lactamases was established. The course of asymptomatic bacteriuria in pregnant women with non-diabetic glomerulopathy was characterized by a moderate tendency to relapse and moderate release of resistant pathogens. The course of asymptomatic bacteriuria in patients with diabetic nephropathy and after kidney transplantation, on the contrary, had a pronounced tendency to relapse and the frequent release of resistant pathogens. Exacerbation of chronic pyelonephritis proceeded with minimal clinical manifestations, a vivid clinical picture of exacerbation of the disease was determined in one third of pregnant women. It was characterized by a high tendency to relapse and the development of systemic infection, a high frequency of release of resistant pathogens. Pregnant women with CKD who underwent UTI had a high risk of giving birth to premature babies (23% versus 11% p=0.01) who were required to carry out artificial lung ventilation and transfer to stage nursing (34% versus 16%, p=0.01). Conclusion The course of UTI in pregnant women with CKD is characterized by a high prevalence, dependence on primary renal disease, the release of resistant pathogens, and a high probability of an atypical clinical picture.

Antibiotic resistant profile of asymptomatic bacteriuria in pregnant women: a systematic review and meta-analysis

ABSTRACT Objectives Different microorganisms contribute in the pregnancy bacteriuria, which resistance microorganisms limited the therapeutic options for the treatment and increasing the related risks to pregnant women and their pregnancy. Based on this, asymptomatic bacteriuria and the use of inappropriate empirical antibiotics are dangerous in the emergence of pregnancy complications and the incidence of drug resistant. Methods A comprehensive systematic search was performed on all international databases including Scopus, PubMed, Web of Science, Medline, Cochrane library during 2000 – June 2019. This meta-analysis, which was registered by a pre-defined protocol in PROSPRO, carried out in accordance with PRISMA guideline. Relevant articles were included in the analysis if reported the susceptibility pattern of antimicrobial resistance related to asymptomatic bacteria in pregnant women with no acute diseases. Overall prevalence and related 95% confidence interval for resistance in different asymptomatic infections were estimated by inverse variance method. The random effect model was used in case of considerable heterogeneity. Results Results of this analysis demonstrated different resistance rate against studied classes of antibiotics. Nitrofurantoin resistance in E. coli, Klebsiella sp, P. aeruginosa, and Staphylococcus aureus isolates were estimated 0.22 (95%CI: 0.15–0.30), 0.40 (95%CI: 0.26–0.54), 0.81 (95%CI: 0.59–0.97), 0.34 (0.11–0.63), respectively. Subgroups analysis showed highest resistance in E. coli isolates, in Asia and Africa against Cefotaxime and Ampicillin, respectively. Conclusion In summary, increasing resistance rate in urinary tract infection (UTI)-related agents is a risk factor that endangers both mother and fetus. Health care providers should consider screening as the radical part of infection control strategies. Due to low resistance rate to Nitrofurantoin, this drug can be a good choice for UTI treatment in pregnancies, but it should use with caution