High repeat pregnancy rates, low contraception use, and high HIV prevalence among teenagers in South Africa is worrying. Focused interventions targeting teenagers following their first pregnancy need to be urgently implemented.

Background: Urinary tract infection (UTI) is associated with poor maternal and foetal outcomes. There is little information on UTI in pregnancy in South Africa. Objectives: To evaluate the frequency of UTI admissions of pregnant women admitted to a public health facility; and, to describe the outcomes of pregnancies complicated by UTI in our study population. Methods: A retrospective chart review of pregnant women admitted with the diagnosis of UTI during the period of 1 January 2012 to 31 December 2012 was conducted. A midstream urine sample of women admitted with symptoms suggestive of UTI was collected for culture. The diagnosis was confirmed if the culture was positive. The data was analysed using SPSS version 21 and descriptive statistics, viz. percentages, frequency and means were estimated. Results: Of 9,881 admissions, 494 (5%) had a diagnosis of UTI based on clinical features. Sixty had positive cultures and were confirmed as having UTI. Women with UTI had high rates of preterm ruptured membranes (n = 5, 8.3%), preterm deliveries (n = 19, 31.6%), anaemia (n = 26, 43.3%) and renal impairment (n = 4, 6.6%). Two cases of pyelonephritis required admission to an ICU because they developed acute respiratory distress syndrome. The most common pathogen isolated using cultures was Escherichia coli (n = 24, 40%). Only 10% had repeat urine cultures. Conclusion: UTI represents 5% of admissions at the study site. This study highlights the need to improve the quality of care of pregnant women with UTI.

Background: Urinary tract infection (UTI) is associated with poor maternal and foetal outcomes. There is little information on UTI in pregnancy in South Africa. Objectives: To evaluate the frequency of UTI admissions of pregnant women admitted to a public health facility; and, to describe the outcomes of pregnancies complicated by UTI in our study population. Methods: A retrospective chart review of pregnant women admitted with the diagnosis of UTI during the period of 1 January 2012 to 31 December 2012 was conducted. A midstream urine sample of women admitted with symptoms suggestive of UTI was collected for culture. The diagnosis was confirmed if the culture was positive. The data was analysed using SPSS version 21 and descriptive statistics, viz. percentages, frequency and means were estimated. Results: Of 9,881 admissions, 494 (5%) had a diagnosis of UTI based on clinical features. Sixty had positive cultures and were confirmed as having UTI. Women with UTI had high rates of preterm ruptured membranes (n = 5, 8.3%), preterm deliveries (n = 19, 31.6%), anaemia (n = 26, 43.3%) and renal impairment (n = 4, 6.6%). Two cases of pyelonephritis required admission to an ICU because they developed acute respiratory distress syndrome. The most common pathogen isolated using cultures was Escherichia coli (n = 24, 40%). Only 10% had repeat urine cultures. Conclusion: UTI represents 5% of admissions at the study site. This study highlights the need to improve the quality of care of pregnant women with UTI.

Objective The global emergence of drug resistance in Neisseria gonorrhoeae has resulted in the use of a range of antibiotics and is now a public health concern because this pathogen may become untreatable in the future. This study aimed to detect antimicrobial-resistant determinants in N. gonorrhoeae directly from endocervical specimens. Methods Three hundred seven pregnant women were enrolled in this study. Endocervical swabs were collected from consenting women and used for the detection of N. gonorrhoeae. Molecular indicators associated with penicillin, tetracycline, ciprofloxacin, azithromycin, spectinomycin, cefixime, and ceftriaxone resistance were detected by polymerase chain reaction. Results Of the 307 women, 24 (7.8%) tested positive for N. gonorrhoeae. The tetM gene carried on the American-type plasmid was shown to be present in all the specimens. Approximately 87.5% of the specimens carried the penicillinase-producing African-type plasmid, and the gyrase A gene carrying the Ser-91 mutation was shown to be present in 37.5% of the specimens. Mutations associated with azithromycin, spectinomycin, cefixime, and ceftriaxone resistance were not detected in the study specimens. Conclusion The detection of resistance determinants without the need for culture may prove to be more feasible for future epidemiological investigations focused on tracking antimicrobial susceptibility patterns in N. gonorrhoeae.

Objective: To investigate the impact of cervical cell abnormalities detected in the puerperium in association with HIV-1 infection on pregnancy outcomes. Methods:The present study was a secondary data analysis of pregnancy outcomes, Conclusion:Pregnant women with HIV were more likely to be diagnosed with higher grades of squamous cell abnormalities than those without HIV. There was no association between squamous cell abnormalities/HIV comorbidity and adverse pregnancy outcomes.

The detection of Neisseria gonorrhoeae using culture assays is challenging. This study aims to compare different assays for the detection of N. gonorrhoeae. This cross-sectional study was conducted at King Edward VIII Hospital and included 307 antenatal attendees, each willing to provide two endocervical swabs. The first swab was used for culture identification of N. gonorrhoeae, and the second swab was processed for the detection of the pathogen by the TaqMan quantitative polymerase chain reaction (qPCR) assay, an in-house 16S ribosomal RNA ( rRNA) PCR and PCR detection of the opa gene. Culture and the nucleic acid amplification assays were each used as comparator tests in the analysis. Sensitivity and specificity were calculated using RS Studio. The prevalence of N. gonorrhoeae was 7.8%. When compared to the TaqMan assay, the 16S rRNA PCR exhibited the highest sensitivity of 62%, with a substantial level of agreement (kappa level of agreement: 0.60), followed by the opa PCR (38%) with a moderate level of agreement (0.52) and culture exhibiting the lowest sensitivity of 25% with a fair level of agreement (0.38). The diagnostic accuracy of all the assays was >90%. The TaqMan qPCR assay has the ability to serve as a future diagnostic assay for the detection of N. gonorrhoeae.