Urinary Tract Infection In Pregnancy Research Articles

Urinary tract infections in pregnancy caused by carbapenemresistant <i>Enterobacteriaceae</i> in University of Calabar Teaching Hospital, Nigeria: An emerging therapeutic threat

Background: Severe infections caused by carbapenem-resistant Enterobacteriaceae (CRE) have mortality rate exceeding 50%. On the strength of this, this study sought to determine the prevalence of urinary tract infection (UTI) in pregnancy caused by CRE and associated risk factors in University of Calabar Teaching Hospital (UCTH), Nigeria, with the aim of making recommendations that can stem the tide of UTI caused by this bacterial strain in the hospital.Methodology: This was a descriptive cross-sectional study of 349 consecutively selected pregnant women attending antenatal clinic of UCTH, Calabar, Nigeria, between September 2020 and August 2021. Demographic/ clinical data and risk factors were collected with semi-structured interviewer-administered questionnaire. Voided mid-stream urine (MSU) sample was collected from each participant and transported to the medical microbiology laboratory of the hospital for microbiological analysis using conventional culture and biochemical identification methods. Antimicrobial susceptibility test (AST) on each isolate was performed by the disk diffusion technique against selected antibiotics. Phenotypic carbapenemase production from presumptive carbapenem resistant isolates following AST was confirmed by the modified Hodge test (MHT). Data analysis was done on SPSS version 19.0. Association of risk factors with prevalence of UTI caused by CRE was determined using Chi square or Fisher Exact test, with p<0.05 considered statistically significant.Results: The prevalence of UTI among the pregnant women was 10.0% (35/349), with prevalence of 6.6% for Escherichia coli (23/349) and 3.5% (12/349) for Klebsiella pneumoniae. Antibiotic susceptibility test result showed that piperacillin-tazobactam was the most active antibiotic in vitro, with 82.9% isolates sensitive to it while sensitivity to imipenem (60.0%) and meropenem (40.0%) was low. A total 17 (48.6%) of the 35 isolates were resistant to carbapenems in the AST and 12 (34.3%) were carbapenemase-producing strains on MHT while 5 (14.3%) were non-carbapenemase-mediated resistance (NCMR). None of the demographic characteristics or risk factors analysed was significantly associated with UTI caused by CRE in the pregnant women (p>0.05).Conclusion: To stem the rising trend of UTIs in pregnancy caused by carbapenem resistant uropathogens,pregnant women receiving antenatal care in UCTH, Calabar should be routinely screened for UTI and offeredappropriate treatment if indicated based on microbiological test results.
 Contexte: Les infections graves causées par des entérobactéries résistantes aux carbapénèmes (CRE) ont un taux de mortalité supérieur à 50 %. Forte de ces éléments, cette étude a cherché à déterminer la prévalence des infections des voies urinaires (IVU) pendant la grossesse causée par la CRE et les facteurs de risque associés à l'hôpital universitaire de Calabar (UCTH), au Nigeria, dans le but de formuler des recommandations qui peuvent endiguer la marée d'infections urinaires causées par cette souche bactérienne à l'hôpital.
 Méthodologie: Il s'agit d'une étude transversale descriptive portant sur 349 femmes enceintes sélectionnées consécutivement fréquentant la clinique prénatale de l'UCTH, Calabar, Nigeria, entre septembre 2020 et août 2021. Les données démographiques/cliniques et les facteurs de risque ont été collectés à l'aide d'un questionnaire semi-structuré administré par un intervieweur. Un échantillon d'urine mi-jet (MSU) a été collecté auprès de chaque participant et transporté au laboratoire de microbiologie médicale de l'hôpital pour analyse microbiologique à l'aide de méthodes de culture et d'identification biochimiques conventionnelles. Le test de sensibilité aux antimicrobiens (AST) sur chaque isolat a été réalisé par la technique de diffusion sur disque contre des antibiotiques sélectionnés. La production phénotypique de carbapénémase à partir d'isolats présumés résistants aux carbapénèmes après AST a été confirmée par le test de Hodge modifié (MHT). L'analyse des données a été effectuée sur SPSS version 19.0. L'association des facteurs de risque avec la prévalence des infections urinaires causées par la CRE a été déterminée à l'aide du test du Chi carré ou de Fisher Exact, avec p <0,05 considéré comme statistiquement significatif.
 Résultats: La prévalence des infections urinaires chez les femmes enceintes était de 10,0% (35/349), avec une prévalence de 6,6% pour Escherichia coli (23/349) et de 3,5% (12/349) pour Klebsiella pneumoniae. Les résultats du test de sensibilité aux antibiotiques ont montré que l'association pipéracilline-tazobactam était l'antibiotique le plus actif in vitro, avec 82,9% des isolats qui y étaient sensibles, tandis que la sensibilité à l'imipénème (60,0%) et au méropénème (40,0%) était faible. Au total, 17 (48,6%) des 35 isolats étaient résistants aux carbapénèmes dans l'AST et 12 (34,3%) étaient des souches productrices de carbapénémase sur MHT, tandis que 5 (14,3%) étaient des souches non médiées par la carbapénémase (NCMR). Aucune des caractéristiques démographiques ou des facteurs de risque analysés n'était associée de manière significative aux infections urinaires causées par la CRE chez les femmes enceintes (p>0,05).
 Conclusion: Pour endiguer la tendance croissante des infections urinaires pendant la grossesse causée par des uropathogènes résistants aux carbapénèmes, les femmes enceintes recevant des soins prénatals à l'UCTH de Calabar devraient être systématiquement dépistées pour les infections urinaires et se voir proposer un traitement approprié si cela est indiqué sur la base des résultats des tests microbiologiques.

Management of Urinary Tract Infection in Pregnancy

Urinary tract infection is a frequent occurrence in pregnancy that can increase the risk of complications; therefore, it is essential to investigate it at the first prenatal consultation. It is classified as asymptomatic bacteriuria, cystitis, and pyelonephritis. This research aims to determine the most appropriate treatment for urinary tract infections during pregnancy according to the best available evidence. The methodology implemented a clinical question: What is the best treatment for urinary tract infections during pregnancy? The PICO format helped search for scientific information, such as the pregnant women’s population with urinary tract infections, whether the intervention received was an antibiotic treatment, was the comparison a no antibiotic treatment, and the result of preventing complications during pregnancy. The databases consulted were PubMed, Cochrane Library, the ACCESSSS search engine, Epistemonikos, DynaMed, and UpToDate. As a result of the information search process, 305 articles were obtained, of which 255 were discarded for not being within the inclusion criteria and 51 were used in this investigation. Of these 50 articles, 15 were eliminated because they were duplicates and 37 were used in this review. In conclusion, urinary tract infection causes increased perinatal maternal morbidity and mortality; therefore, it is essential to investigate and treat it.
 Keywords: urinary tract infections, pregnancy, drug therapy.
 Resumen 
 La infección del trato urinario es una afectación frecuente en el embarazo que puede aumentar el riego de complicaciones, por lo tanto, es fundamental investigarla desde la primera consulta prenatal, se clasifica en bacteriuria asintomática, cistitis y pielonefritis. El objetivo de esta investigación es determinar el tratamiento más adecuado para los cuadros de infección del tracto urinario durante el embarazo de acuerdo a la mejor evidencia disponible. En la metodología se implementó como pregunta clínica ¿cuál es el mejor tratamiento para la infección del tracto urinario durante el embarazo? bajo el formato PICO que ayudó en la búsqueda de información científica, la población son las mujeres gestantes con infección del tracto urinario, la intervención es el tratamiento antibiótico recibido, la comparación fue el no tratamiento antibiótico y el resultado la prevención de complicaciones durante el embarazo. Las bases de datos consultadas fueron PubMed, Cochrane Library, el buscador ACCESSSS, Epistemonikos, DynaMed y UpToDate. En el resultado del proceso de búsqueda de la información se obtuvo 305 artículos de los cuales se descartaron 255 por no estar dentro de los criterios de inclusión y se utilizaron 51 artículos que se servirán en esta investigación; de estos 50 se eliminan 15 artículos por estar duplicados y finalmente 37 artículos se utilizarán para la elaboración de esta revisión. Como principales conclusiones tenemos que la infección del tracto urinario causa aumento de la morbimortalidad materno perinatal, por lo tanto, es fundamental investigarla y tratarla.
 Palabras Clave: infecciones urinarias, embarazo, quimioterapia.

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.

Extended-Spectrum Beta-lactamase and Metallo-beta-lactamase Production among Escherichia coli and Klebsiella pneumoniae Strains from Urine of Pregnant Women in Afikpo, Ebonyi State, Nigeria

Aim: The aim of this study was to determine the occurrence of Extended-spectrum beta-lactamase (ESBL) and Metallo-beta-lactamase (MBL) among Escherichia coli and Klebsiella pneumoniae strains from pregnant women attending Mater Misericordia Hospital Afikpo, Ebonyi state, Nigeria.
 Study Design: This is a laboratory based prospective study carried out on pregnant women suspected of having urinary tract infection and was requested to undergo diagnosis at microbiology laboratory of the hospital.
 Place and Duration of Study: The study was conducted in the Department of Science Laboratory Technology, Akanu Ibiam Federal Polytechnic, Unwana, Afikpo, Ebonyi State, Nigeria from October, 2022 to January, 2023.
 Methodology: Clean-catch midstream urine samples were collected from 206 pregnant women suspected of having urinary tract infection and were requested to undergo medical diagnosis at microbiology laboratory of the hospital. The urine samples were processed following standard microbiological procedure. Antimicrobial susceptibility testing was determined using the disc diffusion method, while ESBL phenotypes were determine by the Double-Disc Synergy Test (DDST). Disc potentiation test was performed to check for MBL production.
 Results: Out of the 206 urine samples processed, 24 (11.7 %) E. coli and 12 (5.8 %) K. pneumoniae were isolated. The antimicrobial susceptibility of the isolates recorded a 100 % resistance with Amoxicillin/Clavulanic acid and Cotrimoxazole. The Gram-negative isolates showed a high sensitivity of 100 % to Netilmicin, Meropenem and Ofloxacin. Overall, 35 (97.2 %) multidrug resistance (MDR) was observed of the bacteria isolates. A total of 9 (37.5 %) E. coli and 4 (33.3 %) K. pneumoniae was found positive for ESBL production whereas, 5 (20.8 %) E. coli and 2 (16.7 %) K. pneumoniae were MBL positive.
 Conclusion: The level of drug resistance in this study underscores the need for regular surveillance for effective management of urinary tract infection in pregnancy.

Knowledge, attitude and practice of antenatal mothers toward urinary tract infection in selected health facilities in Ekiti state, Nigeria.

Urinary Tract Infections (UTIs) during gravidity are among the most preponderant contagion globally and can culminate in fetal and maternal mortality. Lack of awareness and poor preventive practices can exacerbate this outcome. This study assessed the knowledge and preventive practices of antenatal mothers' towards UTIs in pregnancy. This was a cross-sectional descriptive survey involving antenatal mothers in selected health care facilities in Ekiti State. A pre-tested adapted questionnaire was used for data collection. Data was analyzed using descriptive statistics and Chi-square at p < 0.05. The mean respondents' age was 24.6 ± 2.1 years and barely less than half (43.8%) were multigravida. The findings of the study revealed that 64.0% of the respondents had good knowledge of UTIs. Overall, majority (78.9%) of the respondents exhibit good preventive practices toward UTIs in pregnancy, although the prevalence of UTIs among the studied subjects was found to be high (54.1%), with nearly half (48.7%) of the respondents reported been tested once for UTIs in the current pregnancy. Furthermore, there was a statistically significant relationship between educational level and respondents' knowledge on the prevention of UTIs in pregnancy (p = 0.00; p < 0.05). Respondents had good knowledge and good preventive practices toward UTIs. However, the high prevalence of UTIs reported among respondents justifies the need for implementation of knowledge enhancement program, routine testing and prompt treatment of UTIs among antenatal mothers.

Edukasi dan Pemeriksaan pada Ibu Hamil tentang Bahaya Infeksi Saluran Kemih pada Kehamilan

Hormonal changes in pregnant women are a process of preparing for the birth of a baby, pregnant women are very sensitive to infections from various microorganisms. Urinary tract infection is the most common bacterial infection in pregnancy, increasing the risk of morbidity and mortality of mothers and newborns. A white blood cell count of more than 15,000/mm3 is an indication of infection in pregnant women. Caused by viral, bacterial and protozoal infections. Infection in pregnant women must be detected early, in order to prevent preterm labor. One of the tests that can be done is to count the number of erythrocytes and leukocytes. This study was conducted to determine the results of erythrocytes and leukocytes in pregnant women. Community service education for pregnant women about the dangers of urinary tract infections in pregnancy to educate and inform health. Community service activities in the form of creative education through the presentation of poster and presentations are carried out directly at the bancaran village hall. Community service activities in the form of creative education related to education for pregnant women about the dangers of urinary tract infections in pregnancy in the Bancaran sub-district area were carried out well, and received a positive enthusiastic response.

Prevalence and Resistance Pattern of Uropathogens in Pregnant Women- A Cross-Sectional Study

Introduction: Urinary Tract Infection (UTI) is the most common medical problems associated with pregnancy occurring in about 5-10% of pregnant women. It is attributed by various micro- organisms. As the uropathogens is usually Multidrug resistance so, timely identification of these uropathogens and their resistance pattern detection is essential. If UTI is not treated promptly, it can lead to various complications and ultimately can affect health of infant or the pregnant mother. Aim: To estimate the frequency of UTI and different micro- organisms in pregnant women as well as their antibiotic resistant pattern among them. Materials and Methods: Present study was conducted in a tertiary care hospital in rural district of Chhattisgarh. During the study period from August 2021 to October 2021, 130 urine samples were collected and processed as per standard protocol. With significant growth on culture ≥105 Colony Forming Unit (CFU)/mL of single morphotype bacteria from a clean catch midstream urine sample UTI diagnosis was established. The bacteria isolated were identified up to species level by standard biochemical tests. Results: In this study, UTI was found in n=69.2% of pregnant women. The most frequently isolated organism was E. coli (53.3%), followed by Klebsiella spp.(18.9%) and Pseudomonas spp. (3.3%). Highest prevalence rate (85.7%) was observed in the age group 21 to 25 years; most of these (77.8%) were in their 2nd trimester. The isolated pathogens mostly showed multiple drug resistance to two or more antibacterial agents tested. Conclusion: There was higher incidence of UTI in pregnancy and the most predominant organism isolated was E. coli; in 2nd trimester UTI was more common and high level of multidrug resistance was observed. In pregnancy, continuous monitoring of uropathogens including their resistance pattern is required.

Prevalence, Clinico-Bacteriological Profile, and Antibiotic Resistance of Symptomatic Urinary Tract Infections in Pregnant Women.

Urinary tract infection (UTI) is a common complication in pregnancy. The prevalence varies between countries. This research aims at estimating the prevalence, clinico-bacteriological profile, antibiotic resistance, and risk factor analysis of symptomatic UTI in pregnancy. This is a prospective observational study conducted at the Abdullah Bin Omran Hospital, RAK, UAE, from March 2019 to February 2020. All pregnant women attending the antenatal clinic during this period were given a pre-validated questionnaire for the symptoms of UTI. In symptomatic patients, urine was sent for microscopy, culture, and sensitivity. Women were treated for UTI and were followed up for the rest of the pregnancy. Data analysis was performed by SPSS software version 24 using descriptive statistics and comparisons with significance at a p-value of &lt;0.05. The prevalence of symptomatic UTI was 17.9%. E.coli was the commonest isolate followed by Group B streptococcus. The commonest symptom reported was loin pain and the most common risk factor was diabetes. Women with risk factors are significantly more likely to have culture-positive UTIs. Most of the pathogens were sensitive to cefuroxime and benzyl penicillin. Risk of preterm labor was higher. Regular antenatal care and routine urine testing in all visits are recommended for early detection and treatment of UTI.

Which Antibiotic for Urinary Tract Infections in Pregnancy? A Literature Review of International Guidelines.

Urinary tract infection (UTI) is considered to be a major problem in pregnant women. It is also one of the most prevalent infections during pregnancy, being diagnosed in as many as 50-60% of all gestations. Therefore, UTI treatment during pregnancy is extremely important and management guidelines have been published worldwide to assist physicians in selecting the right antibiotic for each patient, taking into account the maternal and fetal safety profile. A review of the literature was carried out and all international guidelines giving recommendations about antibiotic treatments for pregnancy-related UTI were selected. The search came back with 13 guidelines from 4 different continents (8 from Europe, 3 from South America, 1 from North America and 1 from Oceania). Our review demonstrated concordance between guidelines with regard to several aspects in the antibiotic treatment of UTI during pregnancy and in the follow-up after treatment. Nonetheless, there are some areas of discordance, as in the case of antenatal screening for bacteriuria and the use of fluoroquinolones in lower or upper UTI. Given the current evidence that we have from international guidelines, they all agree on several key points about antibiotic use.

Management of Urinary Tract Infections in Pregnancy

Urinary tract infection (UTI) the most common bacterial infection found in pregnant women. Urinary tract infection (UTI) is a condition in which the bacteria or microbes grow and multiply in the urinary tract. Anatomical and physiological changes during pregnancy such as urinary stasis and vesicoureteric reflux will make pregnant women easier to developing UTI. In general, the management of UTI is by antibiotics. The administration of antibiotics is adjusted according to the type of UTI in the patient and based on the results of the sensitivity of urine culture. So it is very important to identify the type of UTI in diagnosis and management of UTI in pregnancy.

Prevalence and Risk Factors of Preterm Premature Rupture of Membranes in Pregnant Women admitted to Hospital, Pakistan

In both high- and low-income nations, preterm pre-labou membrane rupture is a significant contributor to perinatal, neonatal, and maternal illness and mortality. Premature membrane rupture puts a woman at risk for postpartum haemorrhage, intraamniotic infection, and even death. The purpose of this study was to ascertain the prevalence of preterm premature rupture of membranes and its related factors among pregnant women admitted to health institutions because little is known about the issue in the study region. A total of 300 participants participated in this research among which 100 had preterm PROM, 100 had PROM, and 100 had preterm deliveries. The ages of the participants ranged from 18-40 years with a mean age of 25.12 ± 4.43 years. Among 300 participants, 9.33, 17.33, 21, 24.33, and 28% were 18-20, 21-25, 26-30, 31-35, and 40 years of age, respectively. Among the total, 19 (6.33%), 271 (90.33%) and 10 (3.33%) were divorced, married and widowed, respectively. Among a total, 44, 40.33, and 15.66% of the participants were multigravida, primigravida, and grand-multigravida, respectively. The majority (87%) of mothers had ANC follow-up in their current pregnancy. In the large population, 255 (85%) had labor pain while 171 (578%) of mothers showed vaginal bleeding in the current pregnancy and 167 (55.67%) of mothers had cephalic presentation. 88.33% of pregnant women had no history of PROM. 97 (32.33%) of mothers had urinary tract infection in pregnancy, 32 (10.66%) had anaemia, and 41 (13.67%) had an abnormal vaginal discharge. The pregnant mothers had not used any cocaine, and cigarettes. Different risk factors associated with PPROM such as current urinary tract infection, gravidity, history of previous PPROM, preeclampsia, economic status, and anaemia were recorded. The major risk factors are use of smoking, chat, and cocaine. To lower the incidence of preterm premature rupture of membranes, early detection and treatment of urinary tract infections and atypical vaginal discharges were advised. Keywords: Preterm prelabour rupture of membranes; fetal outcome; Female urogenital disorders; maternal age; Pakistan

Diagnostic work-up of urinary tract infections in pregnancy: study protocol of a prospective cohort study

IntroductionSymptoms of urinary tract infections in pregnant women are often less specific, in contrast to non-pregnant women where typical clinical symptoms of a urinary tract infection are sufficient to diagnose...

ANTIBIOTIC SUSPECTIBILITY OF URINARY TRACT INFECTION IN LABOUR WARD AT GOVERNMENT MEDICAL COLLEGE HOSPITAL NAGAPATTINAM, TAMIL NADU

Urinary tract infections (UTIs) are the most common infections after respiratory tract infections. UTIs are frequent during pregnancy, affecting as many as 8% of pregnant women. The presence of discernible bacteria in the urine is known as bacteriuria. The overall prevalence of bacteriuria in pregnancy is estimated to be 4–7%. Most importantly, UTI in pregnancy is mainly related to poor hygiene and the low socio-economic status of developing countries. A total of 38 urine samples were collected for the study. The samples were collected from the patients within the period of 01/10/2020–31/09/2021 at the Government medical College hospital, Nagapattinam, Tamil Nadu. For this study, pregnancy cases were taken. Escherichia coli is the common cause of UTI and is responsible for about 70-80% of acute infections in the general population and 50% of hospital-acquired infections. Gram-negative bacteria (78.9%) including E. coli, Pseudomonas, and Klebsiella species were identied. Gram-positive bacteria (21.0%), staphylococcus and streptococcus were identied. Antimicrobial resistance is one of the considerable causes of treatment failure for UTI. Antibiotic resistance highlights the need for stronger action and the adoption of rules that limit the use of antibiotics.

Occurrence of urinary tract infection and asymptomatic bacteriuria during pregnancy and its association with maternal outcome

: The pregnancy increases the possibility of the case progressing from asymptomatic bacteriuria (ABU) to urinary tract infection (UTI) with symptoms, which may further lead to pyelonephritis and obstetric outcomes. The adverse outcome may result in premature delivery, low weight at birth, and increased foetal mortality. The present study was proposed to assess the occurrence of Symptomatic UTI and asymptomatic bacteriuria, the microorganisms causing UTI in pregnancy, to assess the socio-demographic characteristics involving the risk factors of UTI and the maternal outcome. A total of 152 pregnant women with and without symptoms of urinary tract infection were included as a study subject from January 2011 to April 2011. Midstream urine samples were collected and processed following standard bacteriological tests. In the present study 85 (55.9%) cases were symptomatic UTI and 67 (44.1%) cases were having asymptomatic bacteriuria. was the predominant organism isolated in 61 (49.6%) cases followed by in 24 (19.5%) cases, in 16 (13.0%) cases, CONS 12 (9.7%) cases and in 10 (8.1%) cases. The lower socio-economic status has contributed in 65 (42.8%) cases and the education status of the most of the cases was either high school (47.4%) or primary school (38.8%). Out of 118 cases of vaginal delivery, 101 (85.6%) cases had full term normal delivery, but among 17(14.4%) preterm delivery, 12 (10.2%) were having symptomatic UTI and 05 (4.2%) cases were having asymptomatic bacteriuria.. Our study findings showed that low socioeconomic status and education background were predominant factors associated with increased symptomatic UTI and ABU. There was no significant difference in the prevalence of UTI and ABU with respect to gestational age. It was concluded in the study that the prompt treatment of ABU early in pregnancy significantly reduces the chances of adverse pregnancy outcome. Thus, screening for ABU should ideally be done in the pre-conceptional period. It was also found in our study that higher incidence of UTI was found in third trimester. Hence all pregnant women should be checked for the presence of ABU in the 1st trimester, treated aggressively with suitable antibiotics and promptly followed up.

Topical aspects of laboratory diagnosis of urinary tract infections in pregnancy (literature review)

Numerous scientific studies, as well as practical experience in public health, have determined that proper and timely diagnosis of urinary tract infection (UTI) during pregnancy often determines obstetric and perinatal outcomes, and affects maternal and perinatal mortality rates. Urinary tract infections are common, with a prevalence in pregnancy ranging from 8 to 10%. During pregnancy and delivery, patients with UTIs can develop a number of complications such as anaemia, spontaneous miscarriage, preeclampsia, fetoplacental insufficiency, premature delivery and postpartum septic complications. UTIs also have adverse effects on the fetus, causing fetal hypoxia, delayed intrauterine development and intrauterine infection. Prenatal screening for UTIs is included in the standard of care for pregnant women throughout the world and in some countries, women are screened more than once. Such early diagnosis for asymptomatic bacteriuria is thought to reduce obstetric, perinatal and urological complications by up to a factor of five. However, in some European countries, the socioeconomic feasibility of routine screening of pregnant women for asymptomatic bacteriuria has recently been raised.

Maternal and Perinatal Outcome of Urinary Tract Infection in Pregnancy at Dhulikhel Hospital, Kathmandu University Hospital

Background Urinary tract infection (UTI) is common in pregnancy and poses a great challenge because it has several adverse outcomes in both the mother and her unborn foetus.&#x0D; Objective This study aims to determine the incidence of culture positive urinary tract infection, culture and sensitivity of the common causative organisms and find out the maternal and perinatal outcomes in culture positive urinary tract infection.&#x0D; Method This prospective study was carried out in the Department of Obstetrics and Gynaecology at Dhulikhel Hospital over a period of one year. Urine routine and microscopy was done as a preliminary screening test for urinary tract infection and those with abnormal results were subjected to urine culture and sensitivity and ultrasonological evaluation.&#x0D; Result A total of 162 pregnant women were included in the study. Incidence of culture positive urinary tract infection was 25.9%, highest in age group 15-20 years (47.8%), more in primigravida (30.1%) and common at second trimester (40.4%). Escherichia coli (90.4%) was the commonest organism isolated and ceftriaxone was the most sensitive antibiotic. Patients with culture positive urinary tract infection had higher incidence of anaemia, preterm labour, need of surgical intervention. Such patients also had increased chances of preterm delivery, low birth weight babies and newborn intensive care unit (NICU) admission.&#x0D; Conclusion We conclude that urinary tract infection in pregnancy leads to adverse maternal and fetal outcomes. And we recommend urine culture and sensitivity at each trimester so that urinary tract infection can be diagnosed and treated on time.

Urinary Tract Infection in Pregnancy and Its Effects on Maternal and Perinatal Outcome: A Retrospective Study.

BackgroundA urinary tract infection (UTI) is a common medical condition complicating pregnancy with adverse maternal and perinatal outcomes. This study aimed to assess any adverse maternal and perinatal morbidity related to UTI in pregnancy, focusing on identifying common uropathogens and their antibiotic sensitivity and resistance patterns.MethodsWe conducted a retrospective cohort study at Corniche Hospital, Abu Dhabi. The study population consisted of 549 women in the exposed group (i.e., those with at least one episode of UTI in pregnancy in 2018) and 329 in the comparison group (i.e., those without UTI). Statistical analysis was done using SPSS Statistics for Windows, Version 19.0 (SPSS Inc., Chicago, IL). The study's primary outcome measures were preterm birth, recurrent UTI, pyelonephritis, and low birth weight (LBW).ResultsWomen who had a UTI during pregnancy had more preterm deliveries than those without a UTI (c2=7.092; p=0.007). Recurrent UTI was observed in 26.6% of women with UTI, while the incidence of pyelonephritis was relatively low in this group (1.45%). There was no significant association between LBW and UTI in pregnancy (c2=0.097; p=0.756). The most common bacteria isolated from women with UTI were Group B Streptococcus (GBS, 31.3%), followed by Escherichia coli (30.9%). They were sensitive to a wide range of antibiotics.ConclusionAccording to our results, significant predictors of bacteriuria in pregnancy history include UTI, renal calculi, and nulliparity. Women with UTI in pregnancy are more likely to have preterm delivery. However, adequate management can minimize other complications like pyelonephritis and adverse perinatal outcomes. Available evidence prompts the recommendation of routine screening for asymptomatic bacteriuria (ASB) in early pregnancy to minimize complications and identify those women at significant risk for preterm delivery.

Drug Susceptibility Pattern and Associated Factors of Bacteria Isolated from Urinary Tract Infection among Pregnant Women Attending Antenatal Care in Teaching Referral Hospital, Southeast Ethiopia

Background: Urinary tract infection (UTI) is caused by bacteria from the digestive tract which climbs the opening of the urethra and begins to multiply to cause infection. UTI in pregnancy is associated with significant morbidity for both mother and baby. In most developing countries including Ethiopia, screening for UTI in pregnancy is not considered an essential part of Antenatal Care. This study aimed to assess the bacterial profile and antibiotic susceptibility pattern and associated risk factors among pregnant women in Madda Walabu University Goba Referral Hospital, Southeast Ethiopia. Methods: An institution-based cross-sectional study was conducted from June-August, 2020 . A total of 234 pregnant women were enrolled; data were collected using a structured questionnaire by a trained interviewer. Urine samples were collected from all pregnant women and culture on cysteine lysine electrolytes deficiency medium. Data were analyzed using SPSS 20.0. Descriptive statistics were used to explain the study participants with relevant variables. Logistic regression was used for data comparison. P-value &lt;0.05 was accepted as statistically significant. Results: The overall prevalence of UTI was 23.9% among both asymptomatic and symptomatic groups. Of this screened midstream urine samples showed that 16% and 32.2%, had significant bacteriuria in the asymptomatic and symptomatic groups respectively. The prevalence of UTI was significantly associated with previous history of catheterization and urinary tract infection (p&lt;0.05). E. coli was the most frequently isolated organism (42.9%) followed by coagulase-negative Staphylococcus (26.8%), and S. aureus (12.5%). Gram-negative and Gram-positive bacteria accounted for (59%) and (41%) respectively. Gram-negative isolates showed resistance to ampicillin, naldixic acid and trimethoprim/sulfamethoxazole. Also, all Gram-negative bacterial isolates revealed a high level of resistance against trimethoprim/sulfamethoxazole. Conclusion: Significant bacteriuria has been observed from both symptomatic and asymptomatic pregnant women. The majority of the isolates were resistant to commonly prescribed antibiotics. This calls for an early screening of all pregnant women for UTI and those found to be infected need treatment with an appropriate drug to avoid complications.

COMPARATIVE ASSESSMENT OF FOSFOMYCIN AND NITROFURANTOIN THERAPY IN URINARY TRACT INFECTION DURING PREGNANCY.

Background: Urinary tract infections in pregnancy can be complications if the microbes causing it are proven to be resistant to standard use antibiotics. Routinely a multi-dose regimen of nitrofurantoin is used as a management protocol, however recent literatures have highlighted the relative efficacy of Fosfomycin in successful treatment. The present study was done to comparatively assess the efficacy of single dose Fosfomycin and standard dose nitrofurantoin in UTI among pregnant females, Methodology: Study employed a pool of 60 subjects divided equally in two groups. The groups were provided either with Fosfomycin or nitrofurantoin. Observations: Fosfomycin showed a lower rate of side effects and microbial resistance as compared to nitrofurantoin. The clinical and laboratory analysis revealed a statistically significant superiority of Fosfomycin in the selected study sample. Conclusion: Fosfomycin showed a better outcome compared to nitrofurantoin in the selected study sample.&#x0D; Keywords: Fosfomycin, Nitrofurantoin, Pregnancy, UTI