Urinary Tract Infections In Pregnant Women Research Articles

Prevalence of Uropathogens and Associated Risk Factors in Urinary Tract Infection in Pregnant Women Attending Antenatal Clinic in a Teaching Hospital in Awka, Nigeria

Urinary tract infection (UTI) is one of the very serious common problems encountered in pregnancy, and it is associated with severe maternal and fetal risks which include maternal chorioamnionitis, pyelonephritis, cystitis, preterm birth, low birth weight, and increased perinatal mortality if untreated. The prevalence of UTI varies worldwide. This study was undertaken to determine the prevalence of uropathogens and associated risk factors in UTI in pregnant women in Awka, Nigeria. This was a cross sectional study that involved 269 pregnant women. Clean-catch mid-stream morning urine specimens were collected and examined macroscopically, microscopically and bacteriologically. Information on Socio-demographic characteristics and some clinical factors were collected using pre-designed questionnaires. Statistical analysis was done using SPSS version 22 and the p-value was set at P=0.05. A total of 118 isolates were obtained and the prevalence of UTI in the study population was 39.8%. The most predominant bacterium was Enterococcus faecalis 34(29%), followed by Escherichia coli 21(17.8%), Klebsiella pneumoniae 15(12.7%), Staphylococcus aureus 10(8.4%), Staphyloccocus saprophyticus 7(6.0%), Enterobacter cloacae 6(5.1%), and Staphyloccocus epidermidis 4(3.4%). Citrobacter freundii, Pseudomonas aeruginosa and Proteus mirabilis occurred at frequency of 3(2.5%) each while Pseudomonas oryzihabitans and Morganella morganii occurred at 2(1.7%) each. Candida species were also isolated, including Candida albicans 4(3.4%), Candida krusei 3(2.5%) and Candida guilliermondii 1(0.8%). None of the socio-demographic variables were statistically associated with UTI. Teachings on personal hygiene during every antenatal visit can help prevent UTI in pregnant women.

Urinary tract infections in pregnant women

Urinary tract infections (UTIs) are the most common pathology among pregnant women and are associated with maternal and foetal complications. According to some authors, the incidence of UTIs increased 4 times in the last decades of the 20th century. Escherichia coli is the most predominant pathogen causing up to 80% of UTIs, Klebsiella is ranked second causing up to 8% of UTIs, and pathogenic staphylococcus and mixed microflora are ranked third. To diagnose UTIs, laboratory, physical and radiological diagnostic methods are applied. According to most authors, informative value yielded by lab tests is more than 90%. The prescription of antibacterial chemotherapy should be based on the results of urine culture and sensitivity testing. Before the test results are obtained, broad-spectrum antibacterial drugs (ABs) are usually prescribed. The most commonly used therapy regimens are third-generation cephalosporins with dose adjustments, as may be necessary, after sensitivity is determined. Some authors recommend to continue treatment with urinary tract antiseptics after AB therapy is completed. The impaired urine output should be restored before AB therapy is prescribed. This review presents an analysis of the literature that was found in the databases PubMed (the National Library of Medicine), The Cochrane Library, as well as in the research citation databases (Scopus, Web of Science). The etiological factors and features of the pathogenesis of UTIs in pregnant women, as well as diagnostic standards, are described. The current guidelines for the treatment and prevention of UTIs in pregnant women are considered and antibacterial therapy regimens with current dosage forms are presented. The benefits of using cefixime dispersible forms are described in detail.

Bacterial profile of urinary tract infection among pregnant women: a systematic review

Urinary tract infection (UTI) is the infection and colonization of microorganisms in the urinary tract. Women carry a higher risk of being affected by UTI compared to males, especially during pregnancy due to physiological and hormonal changes. Appropriate and adequate management of UTI reduces the incidence of further maternal and fetal complications. Nonetheless, there is a growing concern regarding resistance to antibiotics among the bacteria causing UTIs in pregnant women. To identify the bacterial profile of UTIs during gestation by exploring the previous research conducted on this subject. A systematic online search was performed on scientific databases to obtain articles related to the current subject using search terms, including bacteria, profile, causative agent, sensitivity, resistance, symptomatic, pregnancy, gestation, and pregnant women. The articles of relevance were considered if they were original articles, written in the English language, available for full-text, and reporting bacterial profile of UTI during pregnancy. A total of eight articles were eligible and met the inclusion criteria. The studies were published between 2020 and 2023 and included a total number of 3,702 pregnant females from five different countries. The bacterial profile of UTI among pregnant women including symptomatic UTI, and resistance and sensitivity of bacteria to antibiotics varied between different regions. However, the causative agents of UTI displayed less variation as Escherichia coli and K.pneomniae were the major causative agents of UTI during pregnancy.

Prevalence and Risk Factors of Urinary Tract Infection in Pregnant Women: Systematic Review and Meta-Analysis

Background: Urinary Tract Infections (UTIs) are the second-most frequent bacterial infections, with an overall incidence of 5-10%. This study aimed to investigate the prevalence and risk factors associated with UTI in pregnant women. Method: A systematic search was conducted in the open domain, electronic databases such as PubMed and Google Scholar. Citation searching was also performed to identify all relevant studies. All the steps were carried out by two independent reviewers to avoid bias. Based on inclusion & exclusion criteria, followed by qualitative evaluation, the studies were included and analyzed by fixed or random effects model using CMA. A sub-group analysis was also performed for Asian and African countries for prevalence and for different categories of risk factors. Results: Out of 45 studies, 41 studies were included for the prevalence of UTI in pregnant women and 19 studies were included to evaluate the risk factors. The pooled prevalence of UTI in African pregnant women was higher when compared to Asian pregnant women (28.6% vs. 20.7%). The risk factors statistically significantly associated with UTI were found to be undergarment texture (silk), history of catheterization, diabetes mellitus, past history of UTI and HIV. Conclusion: UTIs are prevalent in pregnant women in Asian and African pregnant women. Hence, identification of risk factors and frequent screening of UTIs during pregnancy is recommended to avoid maternal-fetal complications.

Prevalence and risk factors of urinary tract infection in pregnant women

Urinary tract infections (UTIs) are the most prevalent in pregnant women. There are associated risk factors that predispose the acquisition of a UTI in pregnancy, which can cause serious complications for mother and child. To determine the prevalence of UTI and associated risk factors in pregnant women at the Hospital Básico de Sangolquí. Observational, cross-sectional, analytical study conducted in 570 pregnant women from January 1 2021 to August 30 2022. The prevalence and risk factors associated with UTI were analyzed through 95% confidence intervals (95% CI) and odds ratio (OR) calculation. The global prevalence of UTI in pregnant women was 37.7% (IC 95% 33.7-41.7). The most frequent etiology was Escherichia coli (65.4%), followed by Staphylococcus spp. (21.8%). The age of pregnant women ranged from 12 to 45 years, with an average of 27.55 ± 7 years, out of which those with a previous history of UTI were at greater risk of presenting UTI (OR 4.05; 95% CI 2.65-6.18), followed by diabetes mellitus (OR 2.25; 95% CI 2.48-3.44), and overweight (OR 1.48; 95% CI 1.05-2.10). Regarding gestational age, the third trimester was a protective factor for UTI (OR 0.65; 95% CI 0.46-0.92]). The prevalence of UTI for pregnant women was 37.7%. The most frequent etiology was Escherichia coli. A history of UTI prior to pregnancy was the main risk factor.

Prevalence of urinary tract infections and antibiotic susceptibility among pregnant women

Urinary tract infection (UTI) is a health problem that must be taken care of during pregnancy. If not treated promptly, UTIs can progress to severe and leave unpredictable complications for both mother and fetus. Currently, in Vietnam, there are few studies on UTIs in pregnancy, especially on pathogens as well as their antibiotic susceptibility characteristics. This study was conducted to determine the bacteria rates among pregnant women with UTI symptoms and antibiotic resistance patterns. In a cross-sectional survey, a total of 178 pregnant women at Thuan Kieu General Clinic from 05/2022 to 07/2022 were recruited. Urine from these patients was cultured on BA, MC, and CHROMagarTM Orientation. The infection ratio was 30.3%. The rate of Gram-positive cocci was 77.8%, and the rate of Gram-negative bacilli was 22.2%. Specifically, the highest proportion was the group of Staphylococcus coagulase negative with 26 samples at 46.3%; Staphylococcus aureus was isolated in all 8 samples at 14.8%; samples infected with Streptococci and Enterococci at 14.8% and 1.9%; 6 samples infected with E. coli with 11.1%; 4 samples infected by Acinetobacter sp with 7.4%; and the remaining were infected with Klebsiella sp with 3.7%. In addition, in the study, two samples of Staphylococci resistant to Methicillin were isolated at 3.7%. The rate of pathogenic bacteria resistant to the old single antibiotics of the β-lactam is high, while the combined antibiotics give good treatment efficiency with both negative and positive cultures. The rate of UTI in pregnant women is 30.3%. Pathogens mainly found include Staphylococcus aureus, E. coli, Klebsiella sp, and Acinetobacter sp. E. coli is no longer the leading cause of UTIs. As a replacement, there was an increase in Gram-positive cocci as Staphylococci. Recommended antibiotics for UTIs are nitrofurantoin, and β-lactam antibiotics in combination, such as amoxicillin-clavulanate, and piperacillin-tazobactam.

Comorbidities of Gestational Diabetes Mellitus and Urinary Tract Infection: A Case Report

Background: Gestational diabetes mellitus (GDM) is defined as a condition of glucose intolerance that is found during pregnancy. In pregnant women, urinary tract infection (UTI) is one of the most common bacterial infections that can be found. The infection can be worsened by diabetes as it was shown that the risk of UTI in pregnant women with diabetes (27.6%) is higher than those without diabetes (3%-10.1%). This study aimed to present a case of gestational diabetes mellitus and urinary tract infection.
 Case presentation: A pregnant woman aged 38 years old with a 15-16 weeks gestational age was admitted with gestational diabetes mellitus and urinary tract infection. The patient was treated with an intravenous insulin drip and antibiotic. The patient was discharged after there was a clinical improvement.
 Conclusion: There are many risk factors that can contribute to the development of UTI in pregnant women, with one of those being inadequate glycemic control. The treatment of UTI in pregnant women with GDM is generally the same as in those without GDM.

Antibiotic sensitivity pattern of uropathogens among diabetic and non-diabetic pregnant women in Dhaka, Bangladesh

Objective: To determine the urinary tract infections (UTIs)-causing bacterial profile and antibiotic susceptibility pattern for the proper and complete treatment of UTIs in pregnant women with diabetes mellitus (DM). Methods: We collected 300 urine samples from diabetic and nondiabetic pregnant women at various gestational ages. After isolating and identifying uropathogens, we conducted an antibiotic sensitivity assay against fourteen commonly used antibiotics: amikacin, amoxicillin, ampicillin, azithromycin, cefixime, ceftazidime, ceftriaxone, cefuroxime, ciprofloxacin, co-trimoxazole, gentamicin, levofloxacin, netilmicin, nitrofurantoin. Results: Among the participants, 70% had DM but only 37.3% had positive uropathogen growth. Five gram-negative bacteria (Escherichia coli, Klebsiella spp., Enterobacter spp., Citrobacter spp., and Pseudomonas spp.) and 3 gram-positive bacteria (Streptococcus spp., Staphylococcus spp. and Enterococcus spp.) were indentified. Escherichia coli was the most prevalent bacteria (57.1%), followed by Klebsiella spp. (19.6%). In the antibiotic susceptibility assay, we found 96.5% of the isolated organisms were highly susceptible to levofloxacin, 94.2% to netilmicin, 88.2% to nitrofurantoin, 85.1% to amikacin, 79.8% to gentamicin, respectively. On the other hand, 64.8%, 63.6%, 61.8% of the isolates demonstrated high-level resistance to ampicillin, ceftazidime and amoxicillin whereas 38.0%, 37.1%, 33.6%, 30.9% and 30.0% of the organisms were resistant to co-trimoxazole, azithromycin, ciprofloxacin, cefuroxime, cefixime, respectivey. Conclusions: Our results suggest that amikacin, levofloxacin, netilmicin, nitrofurantoin, and gentamycin can be used as first-line treatments for UTIs, whether the patient has DM or not. Contrarily, amoxicillin, ampicillin, ceftazidime, azithromycin, and co-trimoxazole should be avoided in treating UTIs.

Association between vaginal microbiota dysbiosis with asymptomatic UTI in pregnant woman and adverse pregnancy outcome- A case report

The vaginal microbiota dysbiosis [Bacterial vaginosis (BV)] is a condition in which the predominant Lactobacillus spp is replaced by anaerobic bacteria like and in the women of reproductive age group due to several factors. The women with BV are at a greater risk of acquiring urinary tract infection (UTI). The association of bacterial vaginosis and asymptomatic UTI in pregnant women pose risk for both mother and foetus. Here, a case of adverse pregnancy outcome in pregnant woman with BV and asymptomatic UTI is reported.

Etiological and susceptibility profile of microorganisms causing urinary tract infection in pregnant women in the city of Palmas, Brazil

Urinary tract infections (UTIs) are inflammatory pathologies resulting from the multiplication of microorganisms in the urinary tract. The risk group includes pregnant women, due to physiological changes caused by pregnancy, and such conditions are related to a greater risk of maternal-fetal complications. Treatment is based on the most likely etiology and should consider microbial sensitivity to antimicrobials, given the increasing emergence of resistance. Given the need to monitor the pathogenic epidemiology and its susceptibility, the study aims to determine the etiological and susceptibility profile of the microorganisms that cause UTI in pregnant women in the city of Palmas, Brazil. This is a descriptive observational study, based on the exploration of data made available by the clinical analysis laboratory of the Dona Regina Hospital and Maternity, located in Palmas. Urine culture and antibiogram results of pregnant women attended over a 12-month period (July/2021 - June/2022) were evaluated. The project was registered on Plataforma Brasil, for appreciation and analysis by the CEP/UFT, thus being adequate to the current regulations. It was found that the etiology of infections was predominantly associated with Escherichia coli (34.75%) and Enterococcus faecalis (23.73%). The drugs with the highest resistance rate were ampicillin (53.47%) and sulfamethoxazole with trimethoprim (41.56%); nitrofurantoin had the lowest rate (3.39%). It is concluded that the etiological profile corresponds to bacteria colonizing the gastrointestinal tract, which have some degree of resistance, especially to ampicillin, and have considerable sensitivity to nitrofurantoin.

Prevalence of E. coli as a causative agent of urinary tract infections and its drug susceptibility patterns among pregnant mothers seeking medicare at Kisii teaching and referral hospital, Kenya

Background: E-coli, a gram-negative entero-bacteria has been associated with urinary tract infections (UTIs) and antimicrobial resistances in human and animals. This study aimed at establishing the prevalence of E. coli among other bacteria causing UTIs in pregnant women seeking Medicare at Kisii teaching and referral hospital (KTRH), Kenya and to establish the drug susceptibility patterns of the isolated E. coli. Setting-The project was done at Kisii teaching and referral hospital, Kenya.Methods: This hospital based experimental and cross-sectional study conducted in 3 months between March and June 2020 involved 119 pregnant women whose urine samples were cultured on Cysteine Leucine Electrolyte deficiency media (CLED) at 370C overnight and sub-cultured on Mueller Hinton media. Bacterial identification was done by Gram stain and biochemical characterization using indole, methyl-red, Voges-Proskaur and citrate tests while susceptibility tests were conducted by Kirby Bauer disc diffusion technique.Results: Out of the 119 urine samples, E. coli 28 (23.5%) was the second most prevalent after S. aureus 40 (33.6%). Others included S. epidermidis 27 (22.7%), and Proteus spp. 9 (7.6%). All E. coli isolates, 28 (100%) demonstrated resistance to sulfamethoxazole followed by amoxyclave 24 (85.75%), and ceftriaxone 20 (71.42%). They were least resistant to gentamycin 4 (14. 28%) and ofloxacin 6 (21.42%).Conclusions: E. coli which largely exists as a commensal can cause UTIs and could be possessing antimicrobial resistant genes responsible for treatment failure. This demands for new effective therapeutic alternatives and more research on bacterial drug resistant.

Awareness of Saudi women about causes of urinary tract infection and its complications in pregnant women in asir region

Background: Urinary tract infection (UTI) is one of the most common infections that occur during pregnancy. It can be symptomatic or asymptomatic and if left untreated, it could lead to maternal and perinatal morbidity and mortality complications. The highest prevalence of UTI in pregnant women is thought to be a result from significant physiological changes occur in the urogenital tract that lead to increasing the potential for pathogenic colonisation. Bladder volume increases and detrusor tone decreases and this will lead to stasis of urine and ascending of infection. In addition, pregnant women develop ureteric dilatation as the result of a combination of progestogenic relaxation of ureteric smooth muscle and pressure from the expanding uterus. Furthermore, this can lead to failure of treatment, recurrent infections, or significant morbidity and mortality with a poor outcome. The bacteria causing urinary infection in pregnancy are many, such as Escherichia coli, Gram-negative bacilli like Proteus mirabilis and Klebsiella pneumoniae. Staphylococcus saprophyticus is the second most frequently cultured uropathogen, 12 while other Gram-positive cocci, such as group B hemolytic streptococci, are less frequently isolated but remain clinically important. Other less common uropathogens include Staphylococcus aureus and Mycobacterium tuberculosis, which can arise through hematological inoculation rather than ascending infection. Nonbacterial causes include Chlamydia species and fungal infections, such as Candida albicans. Aim: The current study aimed to assess the awareness of Saudi women about the causes of UTI and its complications in pregnant women in Asir region, Southern of Saudi Arabia. Methodology: A cross-sectional study enrolled women at Asir region during the study period from Monday Feb 22, 2021–Jul 29, 2021 Data were collected using prestructured online questionnaire using social media platforms. Questionnaire included women bio-demographic data, children number, history of UTI, and awareness regarding UTI and its complications during pregnancy. Results: The study included 1662 Saudi females from Asir region with their ages ranged from 18 to 59 years with a mean age of 27.8 ± 12.4 years old. Majority of study participants (46%; 765) were single. Exact of 66.5% of the study females reported that pregnancy increases the chance of getting UTI. Regarding factors increases the risk of UTI in pregnant women, the most reported by the study females were prolonged retention of urine (72.4%). Also, 53.5% of the females know that the highest risk of getting UTI is at the 3rd trimester. As for complications for a pregnant woman with UTI, nephritis was known among 76.7% of the females. Conclusion: In conclusion, the current study revealed that females' awareness regarding UTI and its related causes and complications is poor in Asir region. Not all females know all risk factors, clinical presentation, or complications of UTI.

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.

Asymptomatic bacteriuria and pyelonephritis during pregnancy

The most common extragenital pathology during pregnancy is urinary tract infection (UTI) of various localization. In some cases, untreated UTI can contribute to the development of obstetric, urological, and perinatal pathologies. Factors predisposing to the UTI manifestation may include increased progesterone, delayed peristalsis, urine retention in the ureters, uterine growth, bladder displacement, and increased residual urine volume. Asymptomatic bacteriuria (ASB) during pregnancy can increase the risk of pyelonephritis and subsequent maternal and fetal complications. Pregnant women should be screened for ASB at least once at the beginning of pregnancy (aft er 14 weeks). E.coli is the dominant uropathogen in 70 – 95% of UTI cases in pregnant women. The main treatment for ABT and pyelonephritis in pregnancy (PiP) is antibiotic therapy (ABT), which is prescribed empirically in most cases. There is currently no consensus on the choice of ABT and the duration of treatment for UTI in pregnant women. In the case of ineff ective drug therapy of PiP, it is necessary to raise the issue of the upper urinary tract drainage promptly.

Virulence and Resistance Characterization of Staphylococci-associated Urinary Tract Infection in Pregnant Women in Lagos, Nigeria

Background: Urinary Tract Infection (UTI) is the most prevalent bacterial infection in developing countries. UTI is sometimes asymptomatic. The occurrence of UTI in pregnancy can result in complications such as premature or low-birth-weight babies. Escherichia coli is the most common cause of UTI followed by Staphylococci species. However, E.coli associated UTI has been well studied while there is paucity of data on the virulence and resistance of Staphylococci-associated UTIs in women. This study aimed to characterize the virulence and resistance genes in Staphylococci species isolated from the urine of pregnant women. Methods: This was a cross-sectional study involving pregnant women attending ante-natal clinic in Lagos State, Nigeria. Clean catch midstream urine specimens were collected from the women and cultured on appropriate agar. Bacteria were identified using both biochemical and molecular methods and evaluated for resistance to antibiotics. Polymerase chain reaction was used to detect the mecA and blaZ resistance genes and the PVL and TSST virulence genes. Results: Staphylococci species were isolated from 21 (26.25%) of the 80 urine samples of which 7 (29%) were Staphylococcus aureus and 17 (71%) coagulase-negative staphylococcus (CoNS). S. epidermidis and S. saprophyticus were the most commonly isolated CoNS. All the isolates tested were resistant to cotrimoxazole, cloxacillin, erythromycin, ampicillin, amoxicillin-clavulanate, and tetracycline. Both blaZ and the mecA genes were detected in the isolates that were phenotypically susceptible to methicillin and cefoxitin. There was an occurrence of the mecA, blaZ and PVL genes in S. saprophyticus in patients who were co-infected with S. aureus. Conclusion: UTI caused by Staphylococci is common among pregnant women. There is a need to consider staphylococcal associated UTI screening in both symptomatic and asymptomatic cases of UTI in pregnant women.

Prevalence of asymptomatic urinary tract infection due to escherichia coli among pregnant women attending ANC clinic at BRIMS teaching hospital

Introduction: Urinary tract infection (UTI) due to Escherichia coli (E. coli) is a common health problem among women. Pregnant women are at increased risk from both symptomatic and asymptomatic UTI because of the physiologic changes associated with pregnancy which may cause complications such as pyelonephritis, chronic renal failure, premature delivery and foetal mortality. Our study aimed to check the prevalence of asymptomatic UTI due to E. coli and its antibiotic profile among pregnant women of Bidar district of North Karnataka, India. Materials and Methods: An independent study was done from January to February 2015 to investigate asymptomatic UTI among pregnant women attending Antenatal care clinic (ANC) of Bidar Institute of Medical sciences (BRIMS) Teaching hospital Bidar. 150 mid-stream urine samples were processed for culture and antimicrobial drug susceptibility testing at Department of Microbiology, BRIMS, Bidar as per the routine microbiological techniques. Diagnosis of UTI was made when there were at least 105 colony forming unit (CFU)/ml of urine. Isolates other than E. coli are not considered for this study. Results: Among 150 samples tested, 65 samples grown E. coli with colony count of 105 CFU/ml of urine. (43.33%).The Majority of pregnant women were in their 2nd and 3rd trimester and the mean age of study population was 23.46. The rate of UTI was highest among age group of 20-25 years. E. coli isolates showed highest resistance to antibiotics Ampicillin (96.92%), Cefuroxime (55.38%) and ceftriaxone (53.85%). It was uniformly sensitive to routinely used drugs for treatment of UTI. Discussion: Many Gram negative and Gram positive organisms including Yeast cause UTI in pregnant women. Our study revealed the high prevalence of asymptomatic UTI among pregnant women due to E. coli in Bidar (43.33%) as compared to studies conducted in other parts Karnataka. This study also showed the antibiotic profile of E. coli to different drugs tested and showed highe

Clinical Features of Urinary Infections in Pregnant Women with Type 1 Diabetes Mellitus

Aim. To study clinical manifestations of urinary tract infections in pregnant women with type 1 diabetes mellitus (DM).Materials and methods. Pregnant women with urinary tract infections (UTIs) were examined: 110 with type 1 diabetes mellitus (main group) and 133 without diabetes mellitus (comparison group). The diagnosis of UTI was based on the clinical picture (for manifestation forms) and confirmed by a dual culture method using both the classical approach and DipStreak tests. The determination of the sensitivity of the isolated microorganisms to antibacterial drugs was carried out by the disk diffusion test on Mueller-Hinton agar using paper disks. Instrumental research included ultrasound of the kidneys, urinary tract and fetoplacental complex.Results. In the main group, UTIs were pyelonephritis, asymptomatic bacteriuria (AB) and low AB (102–104 CFU/ml) was detected in 38, 69 and 31 patients, respectively. In the comparison group, pyelonephritis, AB and low AB was detected in 41, 63 and 29 patients, respectively. In the main group, the classic course of pyelonephritis was observed in 44.7%, low-symptomatic — in 26.3%, “according to the type of carbohydrate metabolism decompensation” — in 21%, and the obstetric variant — in 7.9% of patients. In the comparison group, the classic version of pyelonephritis was in 70.7%, low-symptomatic — in 24.4%, asymptomatic — in 4.9%. Bilateral pyelonephritis in pregnant women with type 1 diabetes mellitus prevailed over unilateral: 65.8 vs 34.2%. During AB, in patients with type 1 diabetes mellitus, hyperglycemia was observed in 23.1% (n = 16), the threat of pregnancy termination in 53.6% (n = 37), and moderate preeclampsia in 17.4% (n = 12). In patients with low AB, glycemia above the target values was recorded in 16.1% (n = 5), the threat of pregnancy termination in 38.7% (n = 12), and moderate preeclampsia in 12.9% (n = 4).Conclusion. Based on the specifics of the clinical manifestations of UTIs in pregnant women with type 1 diabetes mellitus, the following types of pyelonephritis can be distinguished: classic, low-symptom, “decompensation of carbohydrate metabolism” and obstetric. The classical course of pyelonephritis in pregnant women with type 1 diabetes mellitus is statistically significantly less common (p <0.05) as compared with pregnant women without diabetes mellitus. The features of AB in pregnant women with type 1 diabetes mellitus are the development of hyperglycemia and obstetric complications.

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.

Asymptomatic bacteriuria in antenatal women attending tertiary care hospital at Hyderabad

Urinary tract infection (UTI) is one of the most common bacterial infections during pregnancy. Increased risk of UTI in pregnant women is due to anatomical changes and physiological adaptations during pregnancy.Untreated asymptomatic bacteriuria (ASB) in pregnancy predisposes to symptomatic UTI in 25% of infected women.Early diagnosis and appropriate treatment of ASB curbs the risk of pyelonephritis, ecclampsia, preterm delivery and adverse fetal outcomes. This prospective study was conducted to determine the occurrence of ASB, its etiological agents and their antibacterial susceptibility pattern in selected group of pregnant women. Prospective study was carried out on in department of Microbiology at ESIC medical college, Telangana from September 2016 to March 2017. Study population included total of 346 antenatal women of gestational ages 28 weeks or less with no symptoms of urinary tract infection (UTI) attending for antenatal checkup. All bacterial isolates showing significant growth were identified by standard biochemical methods. The antibiotic sensitivity testing of the isolates was be done by Kirby Bauer method according to CLSI guidelines. Among total of 346 antenatal women screened 85.5% samples were sterile. Significant bacterial growth was found in 38 (11%) cases. The age, gravida and trimester of participants did not have any statistical significance on ASB in present study. Escherichia coli (42.1%) and Enterococcus faecalis (42.1%) were most common isolates. Antibiotic sensitivity pattern of Escherichia coli revealed good sensitivity to cefotaxime (93.75%), amikacin (87.5%), nitrofurantoin (87.5%) and cotrimoxazole (81%). Antibiotic sensitivity pattern of Enterococcus faecalis showed good sensitivity of 75% to nitrofurantoin and 67.5% to ampicillin, ciprofloxacin and high level gentamicin. Staphylococcus aureus showed 100% sensitivity to betalactam antibiotics and aminoglycoside.Every pregnant woman in each trimester should have a urine culture done and detected cases should be treated according to the antibiotic susceptibility test in order to reduce the perinatal and maternal morbidity and mortality.

Association Between Sexual and Genital Hygiene Habits With the Urinary Tract Infection During Pregnancy: A Case-Control Study

Objectives: Urinary tract infections (UTIs) are the most common type of infection during pregnancy, which cause serious complications for the mother and baby. The present study was conducted to investigate the relationship between sexual and genital hygiene habits and UTIs in pregnant women. Materials and Methods: This case-control study was conducted on 187 pregnant women including 97 pregnant women with symptomatic bacteriuria (case) and 90 healthy pregnant women (control). Controls were frequency matched with the cases with respect to the number of pregnancy and trimesters of pregnancy. Both groups were compared for the presence of UTI. Finally, the binary multivariate unconditional logistic regression approach was used to evaluate the association between UTI and the confounding variables. Results: The results of this study showed a significant association between UTI in pregnancy and sexual and genital hygiene habits (P<0.05). Based on the binary multivariate logistic regression analysis, attributable risks for UTI included having sexual intercourse >3 times/week (adjusted odds ratio [AOR] =3.68, 95% CI = 2.09-5.41, P=0.001), changing the underwear per week (AOR =1.39, 95% CI=1-1.76, P=0.012), not voiding post-coitus (AOR=2.01, 95% CI=1.34-2.69, P=0.01), washing genitalia from back to the front (AOR=1.96, 95% CI=1.06-2.78, P=0.01), and not washing genitals pre-coitus by the husband (AOR=1.20, 95% CI=0.54-1.9, P=0.024) were among the sexual and hygiene habit variables associated with UTI in pregnant women in this model. Conclusions: In general, sexual and genital hygiene habits are vital preventive actions for controlling the UTI in pregnant women. These actions may lead to UTI complications and a preterm birth reduction. Thus, informing spouses about these practices is highly suggested.