Uropathogens and Gestational Outcomes of Urinary Tract Infections in Pregnancies that Necessitate Hospitalization

Abstract

Background and Objectives: Our aim is to identify uropathogens that cause urinary tract infections (UTIs) that necessitate hospitalization, and analyze outcomes of gestational UTIs. Methods: This study consisted of 30 pregnant women who necessitate hospitalization because of UTI (7.8% of gestational UTIs during the same period of time). UTI that necessitates hospitalization is defined as clinical complaints, urination problems, urine analysis and culture positivity, fever and uterine discomfort. Patients with at least two positive cultures (≥ 100,000 cfu/ml) were included to this study. Antimicrobial susceptibility tests were obtained in all cases in order to determine antimicrobial resistance and to choose the ideal antibiotics for treatment. Results: In our study, we have found that Escherichia coli is the most common microorganism (56.7%). Enterococcus faecalis (13.3%) and Klebsiella pneumonia (10%) were other frequently observed microorganisms. In this series, mean gestational week at birth was 35 weeks 5 days (range 23-40 weeks). Mean birthweight was 2,656 g (range 500-3,700 g). Twenty-three cases (76.7%) were hospitalized before 37th gestational week and preterm delivery rate was 56.3%. Maternal risk factors and coexisting diseases were detected in 11 (36.7%) patients as follows: diabetes mellitus in 4, thrombophilia in 3, thyroid disorders in 3 and hydroureteronephrosis in 1 case. Cesarean section rate was 65.2%. Conclusions: Knowing uropathogens of patient population is beneficial in the management of patients and better planning of future medical treatments. Preterm labor seems to be an important complication in pregnancies with UTIs going together with fever and urination problems.

Uropathogens and antimicrobial susceptibility profiles of asymptomatic bacteriuria among pregnant women receiving antenatal care in traditional birth attendants homes in Ikono, Akwa- Ibom State, Nigeria

“…Other findings have been reported in Turkey, Ethiopia, Cameroon, NigeriaPakistan, and India where Escherichia coli and Klebsiella pneumoniae were the first and second most prevalent pathogens. 2,7,28,[34][35]23,9,25,26,33,31,38 Some authors reported Staphylococcus species or Streptococcus pyogenes to be the second most common uropathogen; but accounting for the third cause of bacteriuria in our study. Variation in geographical location, uses of antibiotic with or with-out prescription by qualify medical personnel are common in rural and urban settlements which may have accounted for these differences.…”

“…7,28,[34][35][36][37] Other documented study reported a lower prevalence of 7.8% among hospitalized pregnant women having ASB in Ankara, Turkey, whereas 5.7% was seen in Douala, Cameroon, 4.5% in Bangladesh, India, and 3.7% in Mbale; Eastern Uganda among pregnant women visiting orthodox clinics for antenatal care. 2,23,38,39 The varying prevalence of ASB among pregnant women from one country to another and among regions of the same country might be due to difference in risk factors associated with a particular geographical region and the methodology adopted by different researchers. Also the women in low socioeconomic status; residing in rural areas might be practicing poor hygiene.…”

“…These are in-line with other reports. 2,3,10,25,26 Glycosuria can also happen in pregnant woman if they develop gestational diabetes during pregnancy. It is a predisposing cause of vaginal thrush and glycosuria was one of the abnormal condition detected in some pregnant women in our study; pointing to the fact that it might cause vaginal thrush in some of them.…”

“…1 If left untreated, UTI could lead to maternal and perinatal morbidity and mortality. 1,2 UTI may be asymptomatic or symptomatic, which often makes diagnosis difficult. In a large number of patients, UTIs are preceded by asymptomatic bacteriuria (ASB).…”

Prevalence and associated risk factors of urinary tract infection in pregnancy at the Douala General Hospital, Cameroon: a case–control study

“…Several microorganisms have been associated with UTI although Escherichia coli is the most frequent accounting for 80 % to 90 % of UTI's in pregnancy [1,[9][10][11].…”