Urinary tract infections in pregnancy

Ovalle, Alfredo; Levancini, Marco

doi:10.1097/00042307-200101000-00008

Cited by 76 publications

(46 citation statements)

References 16 publications

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“…Treatment of UTI is considerably more challenging if the causative agent is resistant to antibiotics (20). In this study, significantly higher levels of antimicrobial resistance, including ESBL production and multidrug resistance, were seen among isolates from Uganda and Vietnam.…”

Section: Discussionmentioning

confidence: 67%

Uropathogenic Escherichia coli Isolates from Pregnant Women in Different Countries

et al. 2012

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Urinary tract infection (UTI) is common during pregnancy and can be associated with negative outcomes for both the mother and fetus. Increased risk of infection among these patients has been attributed to physiological changes, and less focus has been placed on Escherichia coli, the most frequent causative agent. We investigated the virulence properties of isolates causing UTI in pregnant women in Sweden, Uganda, and Vietnam, as well as nonpregnant women in Sweden. Although phylogenetic group B2 was the most prevalent group, more Ugandan isolates belonged to group B1, associated with commensal strains, than isolates from other countries. Adherence to and invasion of urothelial cells, key events in the infection process, were low among group B1 isolates from pregnant Swedish women compared to those from nonpregnant patients. Similar levels of adherence and invasion were seen in isolates from pregnant women in Uganda and Vietnam. More biofilm was formed by group B2 isolates than by those belonging to group B1 and by Ugandan group B2 isolates than by those from pregnant Swedish and Vietnamese women. The antigen 43a-encoding gene, fluA CFT073 , was most prevalent among Ugandan isolates. Expression of the biofilm components, curli and cellulose, was low among all isolates. Multidrug resistance was more common among isolates from Uganda and Vietnam than among those from Swedish patients. We suggest that while bacterial virulence properties play an important role in UTI during pregnancy, physiological changes in the host may contribute more to the incidence of infection caused by less virulent E. coli. U rinary tract infection (UTI) is the predominant type of bacterial infection among pregnant women (7, 18). As many as 90% of UTIs are caused by Escherichia coli (5). Hormonal and physiological changes in the urinary tract, including ureteral dilatation and changes in bladder volume and tone, may promote infection in pregnant women (18). Interestingly, the incidence of UTI during pregnancy is higher among women who have had childhood infections (13). Furthermore, it has been observed that pregnant women have a propensity to develop recurrent UTIs (18).Overall, UTI can be dangerous for both the mother and fetus. Complications that can arise include preterm delivery and increased incidence of intrauterine growth restriction. To a lesser degree, preeclampsia, caesarean delivery, anemia, sepsis, and septic shock may also be associated with UTI in these patients (14). Among patients suffering acute pyelonephritis, those who are pregnant are more likely than nonpregnant women to develop renal scars (22).The possession of virulence factors that enable colonization is important in the pathogenesis of uropathogenic E. coli (UPEC). It has been demonstrated that among isolates causing acute pyelonephritis in pregnant women, expression of type 1, P, and Dr fimbriae can vary by gestational age (19). However, little is known about the prevalence of other E. coli virulence-associated factors, including those known to play a role in lon...

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Section: Discussionmentioning

confidence: 67%

Uropathogenic Escherichia coli Isolates from Pregnant Women in Different Countries

et al. 2012

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“…These include urinary tract infection [14], toxoplasmosis [15], malaria [16][17][18], and various other systemic infections, such as pneumonia [19]. Treatment of lower genital tract infections, including chlamydia and gonorrhea [20], may also have played some role, given that our protocol did not include systematic screening for these conditions.…”

Section: Discussionmentioning

confidence: 99%

Reduction in Preterm Delivery and Neonatal Mortality after the Introduction of Antenatal Cotrimoxazole Prophylaxis among HIV‐Infected Women with Low CD4 Cell Counts

et al. 2006

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Among 255 women with CD4 cell counts <200 cells/ micro L, the percentage of preterm births (< or =34 weeks of gestation) was lower (odds ratio [OR], 0.49 [95% confidence interval {CI}, 0.24-0.98]) after cotrimoxazole prophylaxis was introduced than before; there was a significant decrease in neonatal mortality (9% to 0%; P=.01) and a trend toward increased birth weight ( beta =114 g [95% CI, -42 to 271 g]). In contrast, there were no significant changes in these parameters over the same time interval among women with CD4 cell counts > or =200 cells/ micro L.Conclusion. Antenatal provision of cotrimoxazole for HIV-infected pregnant women with low CD4 cell counts may have indirect benefits for neonatal health.

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“…Women (especially in pregnancy period), renal transplant recipients, patients with a chronic indwelling bladder catheter, stone formers and patients with anatomical or functional abnormalities of genitourinary tracts, are more prone (1)(2)(3)(4)(5)(6). Although a broad range of pathogens can cause UTI, gram-negative bacteria, particularly Escherichia coli is remained the most common (7)(8)(9).…”

Section: Objectivesmentioning

confidence: 99%

Alterations in antibiotic susceptibility of urinary tract infection pathogens

Ghorbani¹,

Ehsanpour²,

Roshanzamir³

et al. 2012

jnp

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Implication for health policy/practice/research/medical education:Urinary tract infection (UTI) is the third most common infection in human. In a study on 32600 ambulatory patients' urine samples from six laboratories, E. coli, Kelebsiella and Enterobacter were the most common pathogens. E. coli and other isolates were more sensitive to Gentamicin, Amikacin and Ciprofloxacin compared to the other antibiotics tested and therefore these may be the drugs of choice for the empiric treatment of community-acquired UTI in our region. Conclusions: E. coli and other isolates were more sensitive to Gentamicin, Amikacin and Ciprofloxacin compared to the other antibiotics tested and therefore these may be the drugs of choice for the empiric treatment of community-acquired UTI in our region.

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Urinary tract infections in pregnancy

Cited by 76 publications

References 16 publications

Uropathogenic Escherichia coli Isolates from Pregnant Women in Different Countries

Uropathogenic Escherichia coli Isolates from Pregnant Women in Different Countries

Reduction in Preterm Delivery and Neonatal Mortality after the Introduction of Antenatal Cotrimoxazole Prophylaxis among HIV‐Infected Women with Low CD4 Cell Counts

Alterations in antibiotic susceptibility of urinary tract infection pathogens

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