Spectrum of uropathogens and their susceptibility to antimicrobials in pregnant women: a retrospective analysis of 5-year hospital data

Abstract

Objective Urinary tract infections (UTI) are common during pregnancy. Identification of antimicrobial susceptibility patterns of microorganisms in pregnant women is important to select the most appropriate antimicrobial. We assessed common uropathogens in pregnant women with UTI and antimicrobial susceptibility, to guide empirical antibiotic selection. Methods In this retrospective study, we analyzed mid-stream urine culture and antibiotic susceptibility data from pregnant women who attended Jordan University Hospital during 2014 to 2018. Data were collected from patients’ charts and urine cultures, and sensitivity results were extracted from the laboratory electronic system. We calculated descriptive statistics and determined correlations among pathogens and antibiotics. Results We examined 612 positive urine cultures from 559 pregnant women, including 163 (29.2%) inpatients. Escherichia coli (29.4%) was the most frequently identified microorganism, followed by coagulase-negative staphylococci (CoNS) (21.6%). All bacterial isolates were sensitive to aztreonam, chloramphenicol, fosfomycin, ofloxacin, pefloxacin, piperacillin, and colistin sulfate; 87.5% were sensitive to amikacin. Only 15.79%, 18.93%, and 17.91% were sensitive to oxacillin, nalidixic acid, and erythromycin, respectively. Conclusion E. coli and CoNS were the most commonly identified microorganisms in this study. We found increased antibiotic resistance in Enterobacter species. The chosen antimicrobial therapy in pregnancy should be determined by sensitivity/resistance and fetomaternal safety.

Urinary bacterial profile and antibiotic susceptibility pattern among pregnant women in Rahima Moosa Mother and Child Hospital, Johannesburg

“…1 The prevalence of UTI in pregnancy ranges between 2% and 10% globally. 2,6,7,8 Urinary tract infections are among the commonest bacterial infections complicating pregnancy. 2,3,4 Urinary tract infection can be either symptomatic or asymptomatic.…”

“…2,6,7,8 Urinary tract infections are among the commonest bacterial infections complicating pregnancy. 2,3,4 Urinary tract infection can be either symptomatic or asymptomatic. A symptomatic UTI patient is one with significant bacteriuria and with symptoms of a UTI.…”

“…9 Other risk factors include: increasing maternal age, high parity, reduced immune function, poor perineal hygiene, a history of recurrent UTI, diabetes mellitus, neurogenic urinary retention, anatomic or functional urinary tract abnormalities, and increased frequency of sexual activity. 2,10,11 Studies in developing countries show that UTIs are usually present at the first antenatal visit and less than 1% of women develop bacteriuria after a negative screen in early pregnancy. 2 A UTI in pregnancy contributes to significant maternal and perinatal morbidity and mortality.…”

“…2,10,11 Studies in developing countries show that UTIs are usually present at the first antenatal visit and less than 1% of women develop bacteriuria after a negative screen in early pregnancy. 2 A UTI in pregnancy contributes to significant maternal and perinatal morbidity and mortality. Maternal complications include overt pyelonephritis in 25% -40% of previously asymptomatic women as the pregnancy progresses, and in 1% -2% in those with symptomatic infections.…”

“…Maternal complications include overt pyelonephritis in 25% -40% of previously asymptomatic women as the pregnancy progresses, and in 1% -2% in those with symptomatic infections. 2,12 Other maternal complications include: anaemia, miscarriages, preterm labour, hypertension, pre-eclampsia, puerperal sepsis, chronic pyelonephritis and occasionally, renal failure. 2,8,13 Urinary tract infections are also associated with foetal growth restriction, prematurity, low birthweight and foetal death.…”