Title: Asymptomatic bacteriuria and drug sensitivity patterns during pregnancy in an Indian Teaching Hospital
Authors: Ajit Kumar Bishoyi, Pradip Kumar Panigrahi, Akankshya Sahu, Mahesh Chandra Sahu
DOI: https://dx.doi.org/10.18535/jmscr/v6i6.155
Abstract
Background: In pregnant women UTI is a major cause for complications during carrying period. It can be solved by proper antibiotic therapy, but without culture sensitivity reveals multi drug resistance strength in empirical therapy.
Materials & Method: Urine samples were collected from UTI pregnant women attending at Out Patients Department of Obstetrics and Gynaecology. Then samples were cultured and identified the organisms with respect to morphology and biochemical tests. Antibiotic sensitivity patterns were carried out with prescribed antibiotics disc in disc diffusion method.
Result: The maximum UTI found on the age group of 30-39 years. E.coli is the most organism followed by S.aureus in this study.
Ceftriaxone and Cefixime was the most susceptible antibiotic for UTI in the pregnant women.
Conclusion: Routine microscopic and culture should be carried out in pregnant UTI women and before empirical therapy culture sensitivity must be carried out to minimize the resistance organism.
Keywords: UTI, Resistant, Pregnant, antibiotics, E. coli.
References
- Urological Problems Inpregnancy. Eur J Obstet Gynecol Reprod Biol. 2010;152:13–7.
- Herráiz Ma, Hernández A, Asenjo E, Herráiz I. Urinary Tractinfections In Pregnancy. Enferm Infecc Microbiol Clin.2005;23:40–6.
- Figueiredo A, Gomes G, Campos A. Urinary Tract Infection Inpregnancy: Diagnosis, Treatment And Prevention. Acta Obstetginecol Port. 2012;6:124–33.
- Hummers-Pradier E, Kochen Mm. Urinary Tract Infections In Adult General Practice Patients.Br J Gen Pract 2002; 52(482):752-761.
- Mclaughlin Sp, Carson Cc. Urinary Tract Infections In Women. Med Clin North Am 2004; 88: 417-429.
- Addo Vn. Urinary Tract Infection In Pregnancy. In: Kwawukume Ey, Emuveyan Ee, Editors. Comprehensive Obstetrics In The Tropics. Dansoman: Asante And Hittscher Printing Press Limited; 2002, P. 261-267.
- Le J, Briggs Gg, Mckeown A, Bustillo G. Urinary Tract Infections During Pregnancy. Ann Pharmacother 2004; 38(10):1692-1701.
- Jeyabalan A, Lain Ky. Anatomic And Functional Changes Of The Upper Urinary Tract During Pregnancy. Urol Clin North Am 2007; 34: 1-6.
- Gilbert Nm, O’brein Vp, Hultgren S, Macones G, Lewis Wg, Lewis Al. Urinary Tract Infection As A Preventable Cause Of Pregnancy Complications: Opportunities, Challenges And Aglobal Call To Action. Glob Adv Health Med 2013; 2: 59-69.
- Demilie T, Beyene G, Melaku S, Tsegaye W. Diagnostic Accuracy Of Rapid Urine Dipstick Test To Predict Urinary Tract Infection Among Pregnant Women In Felege Hiwot Referral Hospital, Bahir Dar, North West Ethiopia. Bmc Res Notes 2014; 7: 481.
- Mittal P, Wing Da: Urinary Tract Infections In Pregnancy. Clin Perinatol 2005, 32:749–7641.
- Gupta K, Hooton Tm, Naber Kg, Wullt B, Colgan R, Miller Lg, Moran Gj, Nicolle Le, Raz R, Schaeffer Aj, Soper De, Infectious Diseases Society Of America, European Society For Microbiology And Infectious Diseases.
- International Clinical Practice Guidelines For The Treatment Of Acute Uncomp-licated Cystitis And Pyelonephritis In Women: A 2010 Update By The Infectious Diseases Society Of America And The European Society For Microbiology And Infectious Diseases. Clin Infect Dis 52:E103–E120.
- Sanchez Gv, Master Rn, Bordon J. Trimethoprimsulfamethoxazole May No Longer Be Acceptable For The Treatment Of Acute Uncomplicated Cystitis In The United States. Clin Infect Dis 53:316–317.
- Sanchez Gv, Master Rn, Karlowsky Ja, Bordon Jm. In Vitro Antimicrobial Resistance Of Urinary Escherichia Coli Isolates Among U.S. Outpatients From 2000 To 2010. Antimicrob Agents Chemother 56:2181–2183.
- Sader Hs, Flamm Rk, Jones Rn. Frequency Of Occurrence And Antimicrobial Susceptibility Of Gram-Negative Bacteremia Isolates In Patients With Urinary Tract Infection: Results From United States And European Hospitals (2009 –2011). J Chemother 26:133–138.
- Zilberberg Md, Shorr Af. Secular Trends In Gram-Negative Resistance Among Urinary Tract Infection Hospitalizations In The United States, 2000–2009. Infect Control Hosp Epidemiol 34:940–946.
- Macleon Ab. Urinary Tract Infection In Pregnancy. Int Jantimicrob Agents. 2001;17:273–6. Krcmery S, Hromec J, Demesova D. Treatment Of Lowerurinary Tract Infection In Pregnancy. Int J Antimicrob Agents.2001;17:279–82.
- Shigemura K, Tanaka K, Adachi M, Yamshita M, Arakawa S, Fujisawa M. Chronological Change Of Antibiotic Use And Antibiotic Resistance In Escherichia Coli Causing Urinary Tract Infections. J Infect Dis Chemother 2011; 17: 646-651.
- Gupta K, Hooton Tm, Stamm We. Increasing Antimicrobial Resistance And The Management Of Uncomplicated Community acquired Urinary Tract Infections. Ann Int Med 2001; 135(1):41-50.
- Sefton Am. The Impact Of Resistance On The Management Of Urinary Tract Infections. Int J Antimicrob Agents 2000; 16(4):489-491.
- Mitchell Aa, Gilboa Sm, Werler Mm, Kelley Ke, Louik C, Hernández-Díaz S, Et Al. Medication Use During Pregnancy, With Particular Focus On Prescription Drugs: 1976-2008. Am J Obstet Gynecol 2011; Doi: 10.1016/J.Ajog.2011.02.029.
- Kladensky J. [Urinary Tract Infections In Pregnancy: When To Treat, How To Treat, And What To Treat With]. Ceska Gynekol 2012;77: 167-171. Czech.
- Nicoll Le. Short-Term Therapy For Urinary Tract Infections:Success And Failure. Int J Antimicrob Agents 2008; 31(Suppl 1):S40-S45.
- Schenkel Df, Dalle J, Antonello Vs. [Microbial Etiology And Susceptibility Of Community Urinary Tract Infections During Pregnancy In The South Of Brazil]. Rev Bras Ginecol Obstet 2014; 36: 102-106. Portuguese.
- Cunningham Fg, Gant Nf, Leveno Kj, Gilstrap Lc Iii, Hauth Jc, Wenstrom Kd. Renal And Urinary Tract Disorders. In: Andrea Seils, Noujaim Sr, Daris K, Editors. Williams Obstetrics. 21st Ed. New York: Mcgraw-Hill Medical Publishing Divsion; 2001:1251–1272.
- Arias F. Abnormalities Of The Urinary System During Pregnancy. In: Daftary Sn, Bhide Ag, Editors. Practical Guide To High Risk Pregnancy And Delivery. A South Asian Perspective. 3rd Ed. New Delhi: Elsevier; 2008:489–505.
- Abdul If, Onile Ba. Bacterial Isolates From Urine Of Women In Ilorin And Their Antibiotic Susceptibility Patterns. Trop J Obstet Gynaecol. 2001;18(2):61–65.
- Ezechi Oc, Fasubaa Ob, Dare Fo. Antibiotic Sensitivity Patterns Of Microbial Isolates From Urine Of Pregnant Women With Urinary Tract Infections. Trop J Obstet Gynaecol. 2003;20(2):113–115.
- Alausa Ko, Montefiore D, Sobayo E. Problems In The Diagnosis Of Urinary Tract Infections. Niger Med J. 1979;9:107–111.
- Onyemenem Tn, Ekweozor Cc. Urinary Tract Infection In Ibadan: Causative Organisms And Antimicrobial Sensitivity Patterns. Afr J Med Sci. 1996;25:165–169.
- Gupta K, Hooton T M, Stamm We. Increasing Antimicrobial Resistance And The Management Of Uncomplicated Community-Acquired Urinary Tract Infections. Ann Intern Med. 2001; 135: 41-50.
- Mordi Rm, Erah Po. Susceptibility Of Common Urinary Isolates To The Commonly Used Antibiotics In A Tertiary Hospital In Southern Nigeria. Afr J Biotechnol. 2006; 5: 1067-1071.
- Chakupurakal R, Ahmed M, Sobithadevi Dn, Chinnappan S, Reynolds T. Urinary Tract Pathogens And Resistance Pattern. J Clin Pathol. 2010; 63: 652-654.
- Goossens H, Ferech M, Vander Stichele R, Elseviers M. ESAC Project Group. Outpatient antibiotic use in Europe and association with resistance: a cross-national database study. Lancet. 2005; 365:579-87.
- Ramos NL, Sekikubo M, Dzung DT. Uropathogenic Escherichia coli isolates from pregnant women in different countries. J Clin Microbiol. 2012; 50:3569-74.
- Del Arco A, Tortajada B, de la Torre J. The impact of an antimicrobial stewardship programme on the use of antimicrobials and the evolution of drug resistance. Eur J Clin Microbiol Infect Dis. 2015; 34:247-51.
- Demilie T, Beyene G, Melaku S, Tsegaye W. Diagnostic accuracy of rapid urine dipstick test to predict urinary tract infection among pregnant women in Felege Hiwot Referral Hospital, Bahir Dar, North West Ethiopia. BMC Res Notes. 2014; 7:481.
- Simerville JA, Maxted WC, Pahira JJ. Urinalysis: a comprehensive review. Am Fam Physician. 2005; 71:1153-62.
- Beer JH, Vogt A, Neftel K, Cottagnoud P. False positive results for leucocytes in urine dipstick test with common antibiotics. BMJ. 1996; 313:25.
- Kupelian AS, Horsley H, Khasriya R Discrediting microscopic pyuria and leucocyte esterase as diagnostic surrogates for infection in patients with lower urinary tract symptoms: results from a clinical and laboratory evaluation. BJU Int. 2013; 112:231-8.
- Leman P. Validity of urinalysis and microscopy for detecting urinary tract infection in the emergency department. Eur J Emerg Med. 2002; 9:141-7.
- Perez JL, Berrocal CI, Berrocal L. Evaluation of a commercial beta-glucuronidase test for the rapid and economical identification of Escherichia coli. J Appl Bacteriol. 1986; 61:541-5.
- Schneeberger C, van den Heuvel ER, Erwich JJ, Stolk RP, Visser CE, Geerlings SE. Contamination rates of three urine-sampling methods to assess bacteriuria in pregnant women. Obstet Gynecol. 2013; 121:299-305.
- Palmqvist E, Aspevall O, Burman E, Nordin G, Svahn A, Forsum U. Difficulties for primary health care staff in interpreting bacterial findings on a device for simplified urinary culture. Scand J Clin Lab Invest. 2008; 68:312-6.
- Mignini L, Carroli G, Abalos E, Widmer M, Amigot S, Nardin JM et al. World Health Organization Asymptomatic Bacteriuria Trial Group. Accuracy of diagnostic tests to detect asymptomatic bacteriuria during pregnancy. Obstet Gynecol. 2009; 113:346-52.
- Director Health Services K. Clinical guidelines for the diagnosis and treatment of common conditions in Kenya. 2002; 18(2, 3).
- Ministry of Health and Social Welfare TURoT. Standard Treatment Guidelines and Essential Medicines List. 2013, 85.
- Ministry of Health Kigali R. Gynecology and Obstetrics Clinical protocols and treatment guidelines. 2012, 71-4.
- Wagenlehner FM, Schmiemann G, Hoyme U. National S3 guideline on uncomplicated urinary tract infection: recommendations for treatment and management of uncomplicated community-acquired bacterial urinary tract infections in adult patients. Urologe A. 2011; 50:153-69.
- Tansarli GS, Poulikakos P, Kapaskelis A, Falagas ME. Proportion of extended- spectrum β-lactamase (ESBL)-producing isolates among Enterobacteriaceae in Africa: evaluation of the evidence–systematic review. J Antimicrob Chemother. 2014; 69:1177-84.
