Urinary Bacterial Profile and Antibiotic Susceptibility in Pregnant Adolescents and Pregnant Low Obstetric Risk Adult Women

Abstract

Introduction: Significant bacteriuria is associated with clinical and obstetric complications. The existing studies on the profile of urinary pathogens in pregnant women have widely divergent results and they hardly include data on pregnant adolescents. Methods: This observational retrospective study was conducted in a tertiary hospital in the city of São Paulo with 388 pregnant adolescents and 2547 pregnant low-risk obstetric care adults who began prenatal care between January 2010 and January 2016. They were compared in terms of urine sediment, urine culture, and antibiogram results. Results: The prevalence of bacteriuria was 17.01% (66/388) among adolescents and 10.13% (258/2547) among adults. Adolescence was a risk factor for bacteriuria in pregnancy (OR=1.82, CI95%=1.35-2.44, p=0.08). The most frequently isolated pathogen in urine culture was Escherichia coli, both in adolescents (49%) and in adults (42.18%). In positive urine cultures, urinary leukocytes were present in greater numbers in adolescents than in adults (p<0.001). Resistance to quinolones in general was more frequent among adults (OR=5.86, CI95%=0.78-44.20, p<0.001), but the tendency was not statistically significant. Conclusion: Escherichia coli and the less frequent Streptococcus agalactiae were the etiologic agents most often found in the urine cultures both of adolescents and adults. Higher rates of bacteriuria and of abnormal urine sediments prevailed among adolescents.

Infección de vías urinarias (IVU) asintomática en pacientes adolescentes: una revisión sistemática en torno al uso inadecuado de medicamentos para su tratamiento

“…En otros casos, se pueden prescribir antibióticos para prevenir la aparición de infecciones recurrentes y reducir el riesgo de complicaciones. Según Diorio et al (2021), la mayoría de los médicos en Brasil prefieren tratar la IVU asintomática en adolescentes con antibióticos.…”

“…La prescripción innecesaria de antibióticos puede llevar al desarrollo de resistencia antimicrobiana y aumentar el riesgo de infecciones recurrentes y complicaciones graves. Por ello, los médicos brasileños a menudo prescriben antibióticos para tratar la IVU asintomática en pacientes adolescentes sin realizar una evaluación adecuada de los síntomas y signos clínicos (Diorio, et al, 2021), lo que sugiere una falta de conciencia sobre las prácticas adecuadas de prescripción (Boon, et al, 2021).…”

Bacteriúria e infecção urinária em gestantes adolescentes: fatores de risco, modelos preditivos, desfechos obstétricos e perfil bacteriano comparativo

“…2.8 (1.9-3.9) 77% (<0.01) 0.024 Enterobacter sp (28,59,67,73,74,76,79,81,83,(86)(87)(88)(89)(90)(94)(95)(96)(98)(99)(100)(101)(102)105,106,108,110,111,113,(115)(116)(117)122,125,126,145,(147)(148)(149)159,161,166,(186)(187)(188)(189)(190)(191)(192)(193)(194)(197)...…”

“…1.4 (0.5-2.5) 89% (<0.01) 0.015 Streptococcus agalactiae (28,59,67,73,74,76,79,81,83,87,89,90,(94)(95)(96)98,99,101,102,105,106,108,110,111,113,(115)(116)(117)122,125,126,145,(147)(148)(149)159,161,166,(187)(188)(189)(190)(192)(193)(194)(197)(198)(199)(201)(202)(203)…”