Urinary Tract Infections In Pregnant Women Research Articles

Prevalence of Bacterial Urinary Tract Infection among Pregnant Women in Wasit Province in Iraq

Background: Urinary tract infections (UTIs) are the most common type of infection during pregnancy. UTI include a spectrum of disorders, ranging from those affecting the lower urinary tract, like asymptomatic bacteriuria and cystitis, to those affecting the kidney, such as pyelonephritis. In pregnancy UTI can lead to preterm labor, anemia and septicemia. Escherichia coli is the most common pathogenic microorganisms associated with UTI and counting up to 60–80% of all UTIs. Objective: The aim of this study is to determine the prevalence of urinary tract infection (UTI) among pregnant women in wasit province. Materials and Methods: Mid-stream urine samples from 100 pregnant women who attending to Al- Shaheed Fairuz hospital and private clinics in wasit province between the periods of March 2024 to July 2024 with the age range of (16-35) years. The urine samples were cultured on MacConkey and blood agars then examined by Macroscopic and Microscopic examination by Gram's stain. The colonies were examined by biochemical tests (Oxidase, catalase, manitol salt agar, novobiocin tests, IMViC) and confirmatory tests (API 20E and API Staph) for isolates. Results: The results showed that the percentage of bacterial growth culture among the pregnant women was 33%. Gram negative bacteria were the higher percentage with (73%). Eschirishia coli bacteria were the most frequently isolated organism (40%) while, the lower percentage for Streptococcus spp. (3%). UTI in pregnant women was commonest in the age group 20-24 years (42%). According to trimesters of pregnancy, the highest percentage of UTI was in third trimester (43%) followed by second trimester (39%), while the the first trimest was the the lowest percentage with (18%). Conclusions: Urinary tract infections (UTIs) are common during pregnancy. Untreated UTIs can lead to complications such as preterm labor, low birth weight and sepsis. E.coli is the predominant pathogen presently causing urinary tract infections at all stages of pregnancy. Urine culture and sensitivity tests are mandatory for all pregnant women during the different trimesters.

Reduction of misdiagnosis in urinary tract infections during pregnancy: The role of adjusted urine flow cytometry parameters.

Urinary tract infections (UTIs) pose a significant health concern, particularly among pregnant women, for whom accurate diagnosis is essential. However, the use of Urine flow cytometry (UF) for detecting UTIs in this demographic often results in misdiagnosis. The objective of this study was to explore the reasons behind these diagnostic errors and to develop a strategy to minimize the rate of UTI misdiagnosis in pregnant women. The study enrolled 1,200 women aged 18 to 40 years, categorized into pregnant and non-pregnant groups. UTIs were diagnosed using urine bacterial culture, microscopic examination, and UF, followed by statistical analysis to identify any discrepancies in diagnosis between the groups. Following the calibration of UF analyzer's parameters, the most effective CR(WBC)-CW-FSC-P Gain setting for diagnosing UTIs in pregnant women through UF was ascertained by applying the Youden index. The clinical diagnosis rate of UTIs was significantly higher in pregnant women (40.91%) compared to non-pregnant women (20.26%). However, urine microscopy and bacterial culture showed no significant difference in the rates of UTIs between the two groups, suggesting a potential for misdiagnosis. The false-positive rate for WBCs detected by UF was 30.43%, and adjusting the CR(WBC)-CW-FSC-P Gain value of UF reduced the false-positive rate to 9.45%. The incidence of UTIs in pregnant women may be overestimated because of the limitations inherent to UF. Adjusting the parameters of the UF analyzer, particularly the CR(WBC)-CW-FSC-P Gain value, can significantly reduce the rate of UTI misdiagnosis in pregnant women.

Imipenem Susceptibility Pattern of Bacterial Isolates on Pregnant Women with Urinary Tract Infection in a Tertiary Hospital

Background: Urinary Tract Infection (UTI) in pregnancy, including Asymptomatic Bacteriuria (ASB) is associated with maternal morbidity and adverse pregnancy outcomes, like preterm birth and low birth weight. In spite of an association of ASB with adverse pregnancy results, screening and treatment is not done with much strength in our country. The antibiotic susceptibility patterns differ from region to region and in different global locations and are found to vary from time to time. This study was done to evaluate the susceptibility pattern of bacterial isolates against Imipenem causing UTI in pregnant women. Materials and methods: This observational study was conducted at the Department of Clinical Pathology, Bangabandhu Memorial Hospital, Chattogram During the period from January to June 2021. Urine sample from a total of 104 pregnant women was enrolled in this study. Isolation and identification of bacteria was done by conventional culture method and Imepenem susceptibility test, by Kirby-Bauer disc diffusion method. Results: Among the study samples, 31(29.8%) showed positive culture result and taken as confirmed UTI. E. coli (45.10%) was the predominant isolated bacteria followed by Klebsiella spp. (25.80%). 90% bacterial isolates were found sensitive to Imipenem and rest 10% were resistant. 93% E. coli showed sensitivity to Imipenem, whereas Klebsiella spp. showed 87.5% and Staphylococcus aureus showed 75% sensitivity to Imipenem. Both Enterococcus spp. and Pseudomonas spp. showed 100% sensitivity to Imipenem. Conclusion: Bacterial resistance against Imipenem is increasing day by day. So it should be kept as a reserve drug for severe life threatening condition. IAHS Medical Journal Vol 6(2), December 2023; 40-43

PREVALENCE OF ASYMPTOMATIC BACTERIURIA IN ANTENATAL WOMEN ATTENDING TERTIARY CARE HOSPITAL-A CROSS-SECTIONAL STUDY

Objective: Urinary tract infection (UTI) is one of the most common bacterial infections during pregnancy due to anatomical changes and physiological adaptations during pregnancy. Asymptomatic bacteriuria is the significant presence of bacteria in the urine of an individual without symptoms. Untreated asymptomatic bacteriuria (ASB) in pregnancy predisposes to symptomatic UTI in 25% of infected women. Screening of antenatal women help in early diagnosis and treatment of ASB and thus to prevent maternal and fetal morbidity and mortality. The present study was carried out to determine the prevalence of UTI in pregnant women and to study the bacteriological profile and antimicrobial sensitivity patterns of uropathogens. Methods: A Cross-sectional study was conducted for a period of six months and midstream urine specimens were collected from 480 pregnant females and were processed by standard protocols. All subjects were clinically identified to have no signs and symptoms of UTI. Antibiotic susceptibility testing was done as per CLSI guidelines. Results: Prevalence rate of asymptomatic bacteriuria was seen 10% in pregnant women. Majority of the culture-positive patients belonged to the age group of 26-30 y (31.25%). 70.84% were Gram-negative isolates and 29.16% were Gram-positive organisms. The commonest pathogen isolated was Escherichia coli (33.33%). In the present study, Extended Spectrum Beta-Lactamase (ESBL) production was seen in (20.58%) isolates, and Metallo Beta-Lactamase (MBL) production was seen in (17.64%) isolates. Conclusion: This study reveals the importance of screening of pregnant women for UTI. Emerging multi-drug resistance seen in uropathogens emphasizes the need to rationalize use of antibiotics, which eventually prevent development of resistant strains.

Diagnostic Accuracy of Urine Dipsticks for Urinary Tract Infection Diagnosis during Pregnancy: A Retrospective Cohort Study.

Urinary tract infections (UTIs) represent the most prevalent infections among pregnant women. Many pregnant women experience frequent voiding or lower abdominal pain during pregnancy due to physiologic changes. Due to the possible consequences of a UTI in pregnancy, pregnant women are more often tested for UTIs. This study aimed to assess the diagnostic accuracy of dipsticks in diagnosing UTIs in pregnant women while using the urine culture as the reference standard. This was a retrospective cohort study, conducted at two academic hospitals in the Netherlands among pregnant women. Pseudonymized data were collected from patient files. The results of the urine dipstick and the urine culture in pregnant women were linked. Additionally, nitrofurantoin prescriptions were linked to culture results. A positive urine culture was considered the reference test for a UTI. Between 1 January 2017 and 28 February 2021, a total of 718 urine samples with leukocyte esterase dipstick results within 24 h of the urine culture were analyzed. Of these samples, a nitrite dipstick result was also available in 337 cases. Only 6.8% of the 718 urine samples yielded positive cultures. The sensitivity and specificity of leukocyte esterase were 75.5% and 40.4%, respectively; for nitrite, 72.0% sensitivity and 73.4% specificity were found. When at least one of the two tests was positive, the sensitivity and specificity were 92.0% and 27.9%, respectively. When both tests were positive, the sensitivity and specificity were 52.0% and 82.7%, respectively. In only 16.8% of the women to whom nitrofurantoin was prescribed, the urine cultures returned positive using a cut-off of 105 colony forming units/mL. The diagnostic performance of leukocyte esterase, nitrite, or their combination in clinical practice is lower than previously reported in study settings among pregnant women. A significant proportion of women treated with nitrofurantoin were found to have no UTI, suggesting potential over-prescription based on dipstick test results. Healthcare providers should be aware of this reduced performance in clinical practice and carefully weigh the risks of antibiotic treatment by suspicion of a UTI against the possibility of delayed treatment awaiting culture results in individual patients.

Analysis of Risk Factors for Urinary Tract Infections in Pregnant Women: A Retrospective Study.

Urinary tract infections (UTIs) are the most common bacterial infection during pregnancy. This study aimed to investigate the risk factors of UTI during pregnancy. In this study, pregnant women who underwent prenatal examination in our hospital from October 2019 to October 2023 were divided into UTI group and non-UTI group in accordance with whether or not they had a UTI. The general data, clinical data and laboratory indicators of the participants were collected. Multivariate logistic regression was used to analyse the influencing factors of UTI in pregnant women, and the results were shown with odds ratio (OR) and 95% confidence interval (95% CI). A total of 600 pregnant women were included in the study. The results found that 56 women (9.33%) had a combined UTI. The results of midstream urinary bacterial culture in the UTI group showed that Gram-negative bacteria accounted for 60.71% of all detected pathogenic bacteria, and Escherichia coli and Staphylococcus aureus were common strains, accounting for 46.43% and 23.21%, respectively. The proportions of patients in the UTI group who were ≥35 years old, had a high school education or below, had a history of abortion, had gestational diabetes, had ≥three vaginal and anal examinations, had a history of UTI and had urinary tract stones were significantly higher than the non-UTI group (p < 0.05). Multivariate logistic regression analysis showed that age ≥35 years (OR = 9.127; 95% CI: 4.668-17.810; p < 0.001), educational level of high school or lower (OR = 4.184; 95% CI: 2.448-7.160; p < 0.001), gestational diabetes (OR = 3.494; 95% CI: 1.789-6.803; p < 0.001), UTI history (OR = 2.074; 95% CI: 1.114-3.834; p < 0.001) and haemoglobin (Hb) <100 g/L (OR = 8.022; 95% CI: 4.532-14.325; p < 0.001) are risk factors for UTI in pregnant women. The common pathogenic bacteria of pregnant women with UTI are mainly Gram-negative bacteria. Older pregnant women, low educational level, gestational diabetes mellitus, history of UTI and anaemia may be risk factors for UTI in pregnant women.

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 resistance of microbial agents causing urinary tract infections in pregnant women

Introduction: urinary tract infection (UTI) is common in pregnant women due to different anatomical, hormonal and functional changes. The incidence of UTI in pregnant women is 5 % to 10 %. This study collected information related to etiological agents, predisposing factors for UTI, mechanisms and antibiotic resistance by etiological agents in pregnant women.Methods: a bibliographic review was carried out in databases in Pubmed, Scopus, Scielo, Elsevier and Google Google Scholar. In which, through the prism method, scientific articles and documents containing updated information published during the period 2018-2023 were selected and included.Results: a thorough search was carried out in different databases and 19 articles were selected, in which it was identified that the most frequent etiological agent was Escherichia coli, followed by Klebsiella pneumoniae. The antibiotic with the greatest resistance by the etiological agents was ampicillin and the main mechanism of resistance in uropathogens was the production of βLEE mainly in Escherichia coli.Conclusions: urinary tract infection is frequent in pregnant women, and resistance to antibiotics has currently been increasing, so it is important to constantly update the pattern of susceptibility and resistance to antibiotics in pregnant women for antibiotic treatment and prevention feto-maternal safety

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.

Urinary tract infections and risk of preterm birth: a systematic review and meta-analysis.

This systematic review and meta-analysis assessed the association between urinary tract infections (UTIs) during pregnancy and the risk of preterm birth (PTB). We searched multiple databases for relevant observational studies, categorizing them as UTI-based (comparing PTB incidence in women with and without UTIs) or PTB-based (comparing UTI prevalence in women with and without PTB). Using a random-effects model in Stata software version 17.0, we estimated pooled and adjusted odds ratios (ORs) with 95% confidence intervals (CIs), and performed subgroup, sensitivity, and cumulative analyses to explore heterogeneity. In total, 30 studies comprising 32 datasets were included, involving a total of 249,810 cases and 2,626,985 healthy controls. The meta-analysis revealed a significant positive association between UTIs during pregnancy and PTB occurrence (OR, 1.92; 95% CI, 1.62-2.27). A sub-group analysis based on studies, the participants showed significant association in both PTB-based (OR, 2.01; 95% CI, 1.58-2.56) and UTI-based studies (OR, 1.79; 95% CI, 1.42-2.26). However, Egger's test indicated the presence of publication bias (p=0.020), and substantial heterogeneity was observed across the included studies (I2=96.6; p< 0.001). These findings emphasize the critical importance of early detection and effective management of UTIs in pregnant women to reduce the risk of PTB and its associated adverse outcomes. While the results highlight a robust link between UTIs during pregnancy and PTB risk, the potential influence of publication bias and substantial heterogeneity should be considered to interpret these findings. Further research is needed to better understand the underlying mechanisms and to develop targeted interventions for high-risk pregnant women.

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 &amp; 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 of urinary tract infection among pregnant women in a tertiary care hospital, Karnataka: Retrospective study

Background: Urinary tract infection (UTI) is a prevalent medical complication during pregnancy, affecting approximately 5–10% of all pregnancies. The risk of recurrent bacteriuria and acute pyelonephritis is heightened during pregnancy, posing significant risks to both mother and fetus. The prevalence of bacteriuria varies across different regions globally. Due to the physiological changes during pregnancy, clinical diagnosis of UTI can be challenging as it is often mistaken for regular pregnancy-related changes. This research aims to determine the prevalence of symptomatic UTI in pregnant women, analyze the bacteriological profile and antibiotic resistance, and identify the associated risk factors. Materials and methods: This cross-sectional retrospective study was conducted at the Kasturba Hospital from January 2017 to December 2021. Patient information was obtained from the medical records. Data analysis was carried out using Jamovi 2.3.26. The level of significance was set at 5% throughout the study. Results: The study included a total of 256 pregnant women, out of which 38 patients exhibited notable bacterial growth, resulting in an overall prevalence of 1.94%. Among the pregnant women, 84% presented with symptomatic bacteriuria. Conclusion: UTI during pregnancy has significant implications for the health of both the mother and the baby. Our findings indicate an incidence rate of 1.94% for UTI in pregnant women. Among the isolated organisms, Escherichia coli was the most commonly identified, with a higher prevalence rate observed in the third trimester of pregnancy. Pregnant women who develop UTI are at an elevated risk of experiencing adverse maternal and fetal outcomes.

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.&#x0D; 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.&#x0D; 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.