| Peer-Reviewed

Urinary Tract Infection and Antibiotic Resistance in Pregnant Women: A Single-Center Cross-Sectional Study

Received: 27 June 2022    Accepted: 6 August 2022    Published: 10 November 2022
Views:       Downloads:
Abstract

Urinary tract infections are one of the most prevalent infectious diseases which frequently reoccur and are difficult to eradicate. OBJECTIVE: To determine the frequency of the most common gram-positive and gram-negative organisms causing urinary tract infections, as well as their sensitivity/resistance to various antibiotics in pregnant women. Methods: A total of 160 cases were included in this cross-sectional study, which was conducted at the in-patient Department of Obstetrics and Gynecology at NESCOM hospital Islamabad. All patients fulfilling the inclusion criteria were enrolled in the study. After taking consent from the patient and explaining the purpose of the study, early morning mid-stream urine samples were collected in a sterile bottle to report pus cells, epithelial cells, and bacteria. If the patient had a urinary tract infection according to the urine report, then a culture and sensitivity test was performed. Results: A total of 160 patients presenting with urinary tract infections were included in the study. The mean age of the patients was 25.06 + 10.04 years. Out of 160 patients, 120 (75%) had asymptomatic UTIs, while 40 (25%) patients had symptomatic UTIs. The most common organisms were Escherichia coli (55.6%) followed by Staphylococcus aureus (18.2%), Klebsiella pneumoniae (11.9%), Pseudomonas aeruginosa (6.9%), Staphylococcus saprophyticus (4.3%) Streptococci (1.9%) and Proteus vulgaris (1.2%). Organisms causing symptomatic UTI were Pseudomonas aeruginosa, followed by Klebsiella pneumoniae, Escherichia coli, Staphylococcus saprophyticus and Staphylococcus aureus. E. coli showed the highest sensitivity to ceftriaxone (71%) but was resistant to cephalexin (89%) and co-amoxiclav (82%). Klebsiella pneumoniae was only 76% sensitive to cefixime and 93% resistant to Co-Amoxiclav. Ceftazidime was 81% effective against Pseudomonas aeruginosa, while cefixime was 69% effective. Pseudomonas aeruginosa was 95% resistant to Cephalexin and 86% resistant to Nitrofurantoin. Staphylococcus aureus was 81% susceptible to cephalexin and 93% resistant to cefixime. Staphylococcus saprophyticus was 97% sensitive to Co-Amoxiclav and 85% resistant to Ceftazidime and Nitrofurantoin. Streptococci sp. were 95% sensitive to Cephalexin and 95% resistant to Ceftazidime 88%. Conclusion: In conclusion, the empirical evidence reaffirms that the selection of medications for the treatment of UTIs is limited due to antibiotic resistance that the prevalent microorganisms display to medications utilised in the past. Drugs like co-trimoxazole and aminopenicillins, which were once thought to be useful against uropathogens, are now infrequently used as empirical therapy in regions with high rates of antibiotic resistance.

Published in Journal of Gynecology and Obstetrics (Volume 10, Issue 6)
DOI 10.11648/j.jgo.20221006.11
Page(s) 236-242
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Sensitivity, Gram Positive, Gram Negative, Urinary Tract Infection

References
[1] Gupta K, Hooton TM, Naber KG. International clinical practice guidelines for the treatment of acute uncomplicated cystitis and pyelonephritis in women: a 2010 update by the infectious diseases society of America and the European society for microbiology and infectious diseases. J Clin Infect Dis. 2011; 52 (5): e103-20.
[2] Getachew F, Gizachew Y, Yitayih W, Zufan S. The prevalence and antimicrobial susceptibility pattern of bacterial uropathogen isolated from pregnant women. Eur J Exp Biol. 2012; 2 (5): 1497-1502.
[3] Gulfareen H, Aftab AM, Nishat Z, Ambreen H. Risk factors of urinary tract infection in pregnancy. J Pak Med Asso. 2010; 213: 60-6.
[4] Hamdan ZH, Abdel Haliem MZ, Salah KA. Epidemiology of urinary tract infections and antibiotics sensitivity among pregnant women at khartoum north hospital. Ann Clin Microbiol Antimicrob. 2011; 10: 2-5.
[5] Muhammad IS, Irfan S, Muhammad SH, Sikandar KS. Frequency of urinary tract infection causing agents in pregnant women and their antimicrobial susceptibility profile. Pak J Biochem Mol Biol. 2013; 46 (34): 107-110.
[6] Okonko IO, Donbraye-Emmanuel OB, Ijandipe LA. Antibiotics sensitivity and resistance patterns of uropathogens to nitrofurantoin and nalidixic acid in pregnant women with urinary tract infections in Ibadan, Nigeria. Middle-East J. Sci. Res. 2009; 4 (2): 105-09.
[7] Meher R, Fatima K, Indu S, Abida M. Rising Prevalence of antimicrobial resistance in urinary tract infections during pregnancy: a necessity for exploring newer treatment options. J Lab Physicians. 2011; 3 (2): 98–103.
[8] Okonko IO, Ijandipe LA, Ilusanya AO, Donbraye-Emmanuel OB, Ejembi J, Udeze AO, et al. Incidence of urinary tract infection (UTI) among pregnant women in Ibadan, South-Western Nigeria. Afr J Biotech. 2009; 8: 6649–57.
[9] Lee, A. C., Mullany, L. C., Koffi, A. K. et al. Urinary tract infections in pregnancy in a rural population of Bangladesh: population-based prevalence, risk factors, etiology, and antibiotic resistance. BMC Pregnancy Childbirth 20, 1 (2020). https://doi.org/10.1186/s12884-019-2665-0
[10] U. Asmat, M. Z. Mumtaz, A. Malik. Rising prevalence of multidrug-resistant uropathogenic bacteria from urinary tract infections in pregnant women. J Taibah Univ Medical Sci, 16 (1) (2020), pp. 102-111.
[11] Tazebew D, Getenet B, Selabat M, Wondewosen T. Urinary Bacterial Profile and Antibiotic Susceptibility Pattern Among Pregnant Women in North West Ethiopia. Ethiop J Health Sci. 2012; 22 (2): 121–28.
[12] Haider G, Zehra N, Afroze Munir A, Haider A. Risk factors of urinary tract infection in pregnancy. J Pak Med Assoc. 2010; 60: 213–216.
[13] R. Cohen, et al. Maternal urinary tract infection during pregnancy and long-term infectious morbidity of the offspring. Early Hum Dev., 136 (2019), pp. 54-59.
[14] Navarro, et al. Reducing the incidence of pregnancy-related urinary tract infection by improving the knowledge and preventive practices of pregnant women. Eur J Obstet Gynecol Reprod Biol., 241 (2019), pp. 88-93.
Cite This Article
  • APA Style

    Maria Tasneem, Sadia Shoukat, Tehreem Zahid, Jahooran Mariyah Bibi Goolamnobee, Nabila Salman. (2022). Urinary Tract Infection and Antibiotic Resistance in Pregnant Women: A Single-Center Cross-Sectional Study. Journal of Gynecology and Obstetrics, 10(6), 236-242. https://doi.org/10.11648/j.jgo.20221006.11

    Copy | Download

    ACS Style

    Maria Tasneem; Sadia Shoukat; Tehreem Zahid; Jahooran Mariyah Bibi Goolamnobee; Nabila Salman. Urinary Tract Infection and Antibiotic Resistance in Pregnant Women: A Single-Center Cross-Sectional Study. J. Gynecol. Obstet. 2022, 10(6), 236-242. doi: 10.11648/j.jgo.20221006.11

    Copy | Download

    AMA Style

    Maria Tasneem, Sadia Shoukat, Tehreem Zahid, Jahooran Mariyah Bibi Goolamnobee, Nabila Salman. Urinary Tract Infection and Antibiotic Resistance in Pregnant Women: A Single-Center Cross-Sectional Study. J Gynecol Obstet. 2022;10(6):236-242. doi: 10.11648/j.jgo.20221006.11

    Copy | Download

  • @article{10.11648/j.jgo.20221006.11,
      author = {Maria Tasneem and Sadia Shoukat and Tehreem Zahid and Jahooran Mariyah Bibi Goolamnobee and Nabila Salman},
      title = {Urinary Tract Infection and Antibiotic Resistance in Pregnant Women: A Single-Center Cross-Sectional Study},
      journal = {Journal of Gynecology and Obstetrics},
      volume = {10},
      number = {6},
      pages = {236-242},
      doi = {10.11648/j.jgo.20221006.11},
      url = {https://doi.org/10.11648/j.jgo.20221006.11},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.jgo.20221006.11},
      abstract = {Urinary tract infections are one of the most prevalent infectious diseases which frequently reoccur and are difficult to eradicate. OBJECTIVE: To determine the frequency of the most common gram-positive and gram-negative organisms causing urinary tract infections, as well as their sensitivity/resistance to various antibiotics in pregnant women. Methods: A total of 160 cases were included in this cross-sectional study, which was conducted at the in-patient Department of Obstetrics and Gynecology at NESCOM hospital Islamabad. All patients fulfilling the inclusion criteria were enrolled in the study. After taking consent from the patient and explaining the purpose of the study, early morning mid-stream urine samples were collected in a sterile bottle to report pus cells, epithelial cells, and bacteria. If the patient had a urinary tract infection according to the urine report, then a culture and sensitivity test was performed. Results: A total of 160 patients presenting with urinary tract infections were included in the study. The mean age of the patients was 25.06 + 10.04 years. Out of 160 patients, 120 (75%) had asymptomatic UTIs, while 40 (25%) patients had symptomatic UTIs. The most common organisms were Escherichia coli (55.6%) followed by Staphylococcus aureus (18.2%), Klebsiella pneumoniae (11.9%), Pseudomonas aeruginosa (6.9%), Staphylococcus saprophyticus (4.3%) Streptococci (1.9%) and Proteus vulgaris (1.2%). Organisms causing symptomatic UTI were Pseudomonas aeruginosa, followed by Klebsiella pneumoniae, Escherichia coli, Staphylococcus saprophyticus and Staphylococcus aureus. E. coli showed the highest sensitivity to ceftriaxone (71%) but was resistant to cephalexin (89%) and co-amoxiclav (82%). Klebsiella pneumoniae was only 76% sensitive to cefixime and 93% resistant to Co-Amoxiclav. Ceftazidime was 81% effective against Pseudomonas aeruginosa, while cefixime was 69% effective. Pseudomonas aeruginosa was 95% resistant to Cephalexin and 86% resistant to Nitrofurantoin. Staphylococcus aureus was 81% susceptible to cephalexin and 93% resistant to cefixime. Staphylococcus saprophyticus was 97% sensitive to Co-Amoxiclav and 85% resistant to Ceftazidime and Nitrofurantoin. Streptococci sp. were 95% sensitive to Cephalexin and 95% resistant to Ceftazidime 88%. Conclusion: In conclusion, the empirical evidence reaffirms that the selection of medications for the treatment of UTIs is limited due to antibiotic resistance that the prevalent microorganisms display to medications utilised in the past. Drugs like co-trimoxazole and aminopenicillins, which were once thought to be useful against uropathogens, are now infrequently used as empirical therapy in regions with high rates of antibiotic resistance.},
     year = {2022}
    }
    

    Copy | Download

  • TY  - JOUR
    T1  - Urinary Tract Infection and Antibiotic Resistance in Pregnant Women: A Single-Center Cross-Sectional Study
    AU  - Maria Tasneem
    AU  - Sadia Shoukat
    AU  - Tehreem Zahid
    AU  - Jahooran Mariyah Bibi Goolamnobee
    AU  - Nabila Salman
    Y1  - 2022/11/10
    PY  - 2022
    N1  - https://doi.org/10.11648/j.jgo.20221006.11
    DO  - 10.11648/j.jgo.20221006.11
    T2  - Journal of Gynecology and Obstetrics
    JF  - Journal of Gynecology and Obstetrics
    JO  - Journal of Gynecology and Obstetrics
    SP  - 236
    EP  - 242
    PB  - Science Publishing Group
    SN  - 2376-7820
    UR  - https://doi.org/10.11648/j.jgo.20221006.11
    AB  - Urinary tract infections are one of the most prevalent infectious diseases which frequently reoccur and are difficult to eradicate. OBJECTIVE: To determine the frequency of the most common gram-positive and gram-negative organisms causing urinary tract infections, as well as their sensitivity/resistance to various antibiotics in pregnant women. Methods: A total of 160 cases were included in this cross-sectional study, which was conducted at the in-patient Department of Obstetrics and Gynecology at NESCOM hospital Islamabad. All patients fulfilling the inclusion criteria were enrolled in the study. After taking consent from the patient and explaining the purpose of the study, early morning mid-stream urine samples were collected in a sterile bottle to report pus cells, epithelial cells, and bacteria. If the patient had a urinary tract infection according to the urine report, then a culture and sensitivity test was performed. Results: A total of 160 patients presenting with urinary tract infections were included in the study. The mean age of the patients was 25.06 + 10.04 years. Out of 160 patients, 120 (75%) had asymptomatic UTIs, while 40 (25%) patients had symptomatic UTIs. The most common organisms were Escherichia coli (55.6%) followed by Staphylococcus aureus (18.2%), Klebsiella pneumoniae (11.9%), Pseudomonas aeruginosa (6.9%), Staphylococcus saprophyticus (4.3%) Streptococci (1.9%) and Proteus vulgaris (1.2%). Organisms causing symptomatic UTI were Pseudomonas aeruginosa, followed by Klebsiella pneumoniae, Escherichia coli, Staphylococcus saprophyticus and Staphylococcus aureus. E. coli showed the highest sensitivity to ceftriaxone (71%) but was resistant to cephalexin (89%) and co-amoxiclav (82%). Klebsiella pneumoniae was only 76% sensitive to cefixime and 93% resistant to Co-Amoxiclav. Ceftazidime was 81% effective against Pseudomonas aeruginosa, while cefixime was 69% effective. Pseudomonas aeruginosa was 95% resistant to Cephalexin and 86% resistant to Nitrofurantoin. Staphylococcus aureus was 81% susceptible to cephalexin and 93% resistant to cefixime. Staphylococcus saprophyticus was 97% sensitive to Co-Amoxiclav and 85% resistant to Ceftazidime and Nitrofurantoin. Streptococci sp. were 95% sensitive to Cephalexin and 95% resistant to Ceftazidime 88%. Conclusion: In conclusion, the empirical evidence reaffirms that the selection of medications for the treatment of UTIs is limited due to antibiotic resistance that the prevalent microorganisms display to medications utilised in the past. Drugs like co-trimoxazole and aminopenicillins, which were once thought to be useful against uropathogens, are now infrequently used as empirical therapy in regions with high rates of antibiotic resistance.
    VL  - 10
    IS  - 6
    ER  - 

    Copy | Download

Author Information
  • Department of Gynecology and Obstetrics, Jinnah Medical and Dental College, Karachi, Pakistan

  • Dr. Ruth K. M. Pfau Civil Hospital, Karachi, Pakistan

  • Shifa International Hospitals Ltd, Islamabad, Pakistan

  • Dr. Ruth K. M. Pfau Civil Hospital, Karachi, Pakistan

  • Department of Gynecology and Obstetrics, NESCOM Hospital, Islamabad, Pakistan

  • Sections