The etiology and prevalence of urinary tract infection and asymptomatic bacteriuria in pregnant women in Iran: a systematic review and Meta-analysis

Azami, Milad; Jaafari, Zahra; Masoumi, Mansour; Shohani, Masoumeh; Badfar, Gholamreza; Mahmudi, Leily; Abbasalizadeh, Shamsi

doi:10.1186/s12894-019-0454-8

Cited by 69 publications

(92 citation statements)

References 32 publications

(26 reference statements)

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“…The most common isolated microorganism involved in the etiology of UTI (61.6% [95% CI: 51.6–70.7]) and ASB (63.22% [95% CI: 51.2–73.8]) was E. coli . [36]…”

Section: Special Considerations – Pregnancymentioning

confidence: 99%

Management of urinary tract infection in women: A practical approach for everyday practice

et al. 2019

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A common health-care problem worldwide, urinary tract infection (UTI), represents a disease of significant impact on every country's economy, being the most common cause of hospitalization among elderly people and the most common cause of antibiotic prescription in primary care. Diagnosing and managing upper and lower UTI have always been a challenge to physicians, given its high prevalence, risk of recurrence and improper treatment, and the fact of worldwide increase in antibiotic resistance, necessitating implementation of a proper antibiotic stewardship. Urinary infections are twice more likely to occur in females compared to males and its prevalence increases with increasing age. The following is a comprehensive review paper about UTI in females, discussing the various factors leading to a complicated infection. The various etiologies and microbiologies of UTI are also highlighted. In addition to various usual antibiotic regimens for treating UTI, a significant number of nonantimicrobial treatment modalities are highlighted and described in this manuscript, including the novel use of intravesical antibiotics and vaccines for suppression treatment. Finally, a pathway is suggested for the proper diagnosis and treatment that ensures antibiotic stewardship in order to decrease long-term complications.

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“…The most common isolated microorganism involved in the etiology of UTI (61.6% [95% CI: 51.6–70.7]) and ASB (63.22% [95% CI: 51.2–73.8]) was E. coli . [36]…”

Section: Special Considerations – Pregnancymentioning

confidence: 99%

Management of urinary tract infection in women: A practical approach for everyday practice

et al. 2019

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“…Various literatures acknowledge the significance of intra-partum fever [25,26,27,28,29,30,31,32,33,34,35,36,37,38] and antenatal urinary tract infections [39,40,41,42,43,44,45,46] in increasing the risk of pregnant mothers to have a newborn with clinical EONS [24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46]. It is so because EONS is associated with the acquisition of microorganisms from the mother during pregnancy and delivery [33,47,48].…”

Section: Introductionmentioning

confidence: 99%

The burden of neonatal sepsis and its association with antenatal urinary tract infection and intra-partum fever among admitted neonates in Ethiopia: A systematic review and meta-analysis

Bayih

Ayalew

Chanie

et al. 2021

Heliyon

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Background: More than one-third of the neonatal death in Ethiopia has been attributed to neonatal sepsis. However, there is no recent national evidence about the burden of neonatal sepsis and its association with antenatal urinary tract infection and intra-partum fever, which are commonly reported maternal morbidities in Ethiopia. Therefore, the aim of this systematic review and meta-analysis was to assess the pooled burden of neonatal sepsis and its association with antenatal urinary tract infection as well as intra-partum fever in the country. Methods: Primary studies were accessed through Google scholar, HINARI, SCOPUS and PubMed databases. The methodological and evidence quality of the included studies were critically appraised by the modified Newcastle-Ottawa quality assessment tool scale adapted for observational studies. From eligible studies, two authors extracted author/ year, study region, study design, sample size, reported prevalence of neonatal sepsis, antenatal urinary tract infection and intrapartum fever on an excel spreadsheet. During critical appraisal and data extraction, disagreements between the two authors were resolved by the involvement of a third author. The extracted data were then exported to stata version 14. Effect sizes were pooled using the random inverse varience-effects model due to significant heterogeneity between studies (I 2 ¼ 99.2%). Subgroup analysis was performed for evidence of heterogeneity. Sensitivity analyses were performed. Absence of publication bias was declared from symmetry of funnel plot and Egger's test (p ¼ 0.244). Results: In this systematic review and meta-analysis, a total of 36,016 admitted neonates were included from 27 studies. Of these 27 studies, 23 employed cross-sectional design whereas 3 studies had case control type and only one study had cohort design. The prevalence of neonatal sepsis among admitted Ethiopian neonates at different regions of the country ranged from 11.7%-77.9%. However, the pooled prevalence of neonatal sepsis was 40.25% [95% CI: 34.00%, 46.50%; I 2 ¼ 99.2%]. From regional subgroup analysis, the highest prevalence was observed in the Oromiya region. Neonates born to mothers who had antenatal urinary tract infection were at 3.55 times (95% CI: 2.04, 5.06) higher risk of developing neonatal sepsis as compared to those neonates born to mothers who didn't have antenatal urinary tract infection. Moreover, neonates born to mothers having intra-partum fever were 3.63 times (95% CI: 1.64, 5.62) more likely to develop neonatal sepsis as compared to those born to mothers who were nonfebrile during intrapartum. Conclusion: Neonatal sepsis has remained a problem of public health importance in Ethiopia. Both antenatal urinary tract infection and intra-partum fever were positively associated with neonatal sepsis. Therefore, preventing maternal urinary tract infection during pregnancy and optimizing the intra-partum care are recommended to mitigate the burden of neonatal sepsis in Ethiopia.

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“…Schnarr and Smaill report that urinary tract infections are among the most common bacterial infections in pregnant women, as 7.4% of the women in their study were diagnosed as having a urinary tract infection and asymptomatic bacteriuria ranged from 2 to 10% [ 16 ]. A meta-analysis by Azami et al for the population of Iranian pregnant women showed the prevalence of asymptomatic bacteriuria to be 8.7% (95% CI: 7.2–10.4), and urinary tract infections–9.8% (95% CI 7.6–12.5) [ 21 ].…”

Section: Discussionmentioning

confidence: 99%

Outpatient Antibiotic Prescriptions in Pregnant Women in Małopolska Province

et al. 2020

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Background: excessive and incorrect use of antibiotics is a common event that contributes to increased bacterial resistance to antibiotics. Based on the European Centre for Disease Control and Prevention (ECDC) European Surveillance of Antimicrobial Consumption (ESAC)-Net reports, outpatient antibiotics prescribing in Poland, is higher than the European average rate. However, ECDC reports do not provide data on consumption in specific patient groups. Additional studies focused on selected patient groups are needed for a more detailed analysis. The use of antibiotics during pregnancy is inevitable due to the proven risk of complications in this period, perinatal infections, and infections in newborns, in the situation of frequent infections of the genital tract, urinary tract, and asymptomatic bacteriuria in pregnant women. The aim of this study was to analyze the use of antibiotics/the implementation of antibiotic prescriptions ordered by gynecologists during pregnancy in pregnant women in Małopolska Voivodeship, with particular emphasis on demographic data and drug groups. Material and methods: the analysis used data on the reimbursement of antibiotics from the Małopolska Health Fund for 2013–2014. The database contained information of a demographic nature: age, place of residence, date of birth, as well as information on the type of drug, and the number of packages purchased by the patients. Results: the study included 67,917 women. During pregnancy, 23.6% filled their prescriptions for antibiotics. In the first trimester, the percentage of women filling their prescriptions for antibiotics was the lowest and amounted to 7.8%, in the second and third trimesters, these were 9.0% and 11.2%, respectively. The inhabitants of rural areas bought antibiotics more often (23.5%). Most frequently, antibiotics were purchased by women under 18 years of age (32.1%), but the use of antibiotics in women aged 18–34 and over 35 was similar, amounting to 23.8% and 22.7%, respectively. Most often (94.78% of cases) monotherapy was used, including beta-lactams and beta-lactams with an inhibitor (67.3%), then second-generation cephalosporins (13.5%), macrolides (14.73%), and others. Prescription of two different preparations was found in 5.06% of cases, three (0.19%), and four or more (0.03%). Conclusions: due to the fact that studies on antibiotic therapy in pregnant women in Poland are rare, it is impossible to assess the situation thoroughly. Additionally, in Poland, the prevalence of gestational infections is unknown, and their diagnostics is important, especially in relation to microbiological diagnostics and targeted treatment. However, the present results indicate the need to implement broad health promotion programs, accessible to all women, also those living outside large cities, particularly promoting the prevention of urinary tract infections and reproductive health in general.

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The etiology and prevalence of urinary tract infection and asymptomatic bacteriuria in pregnant women in Iran: a systematic review and Meta-analysis

Cited by 69 publications

References 32 publications

Management of urinary tract infection in women: A practical approach for everyday practice

Management of urinary tract infection in women: A practical approach for everyday practice

The burden of neonatal sepsis and its association with antenatal urinary tract infection and intra-partum fever among admitted neonates in Ethiopia: A systematic review and meta-analysis

Outpatient Antibiotic Prescriptions in Pregnant Women in Małopolska Province

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