scholarly journals Preponderance of bacterial isolates in urine of HIV-positive malaria-infected pregnant women with urinary tract infection

2014 ◽  
Vol 8 (12) ◽  
pp. 1591-1600 ◽  
Author(s):  
Kwashie Ajibade Ako-Nai ◽  
Blessing Itohan Ebhodaghe ◽  
Patrick Osho ◽  
Ebun Adejuyigbe ◽  
Folasade Mubiat Adeyemi ◽  
...  

Introduction: This study examined HIV and malaria co-infection as a risk factor for urinary tract infections (UTIs) in pregnancy. The study group included 74 pregnant women, 20 to 42 years of age, who attended the antenatal clinic at the Specialist Hospital at Akure, Ondo State, Nigeria. Methodology: Forty-four of the pregnant women were either HIV seropositive with malaria infection (HIV+Mal+) or HIV seropositive without malaria (HIV+Mal-). The remaining thirty pregnant women served as controls and included women HIV seronegative but with malaria (HIV-Mal+) and women HIV seronegative without malaria. UTI was indicated by a bacterial colony count of greater than 105/mL of urine, using cysteine lactose electrolyte deficient medium (CLED) as the primary isolation medium. Bacterial isolates were characterized using convectional bacteriological methods, and antibiotics sensitivity tests were carried out using the disk diffusion method. Results: A total of 246 bacterial isolates were recovered from the cultures, with a mean of 3.53 isolates per subject. Women who were HIV+Mal+ had the most diverse group of bacterial isolates and the highest frequency of UTIs. The bacterial isolates from the HIV+Mal+ women also showed the highest degree of antibiotic resistance. Conclusions: While pregnancy and HIV infection may each represent a risk factor for UTI, HIV and malaria co-infection may increase its frequency in pregnancy. The higher frequency of multiple antibiotic resistance observed among the isolates, particularly isolates from HIV+Mal+ subjects, poses a serious public health concern as these strains may aggravate the prognosis of both UTI and HIV infection.

2021 ◽  
Vol 17 (1) ◽  
pp. 119-129
Author(s):  
R.H. Bello ◽  
Y.K.E. Ibrahim ◽  
B.O. Olayinka ◽  
A.A.G. Jimoh ◽  
N.B. Afolabi-Balogun ◽  
...  

Background: The emergence of multidrug- resistance Enterobacteriaceae especially in E. coli bacteria  associated with Urinary Tract Infections (UTIs) in pregnancy is a serious menace globally posing health challenges and confounding successful empirical treatment as well as increasing pregnancy – related  complications.Objectives: The aim of this study is to determine the phenotypic and genotypic characteristics of Extended Spectrum Beta – Lactamases (ESBLs) producing E. coli (ESBLs – EC) isolates in pregnant women attending ante – natal clinics within Ilorin - Kwara State, Nigeria.Materials and methods: A total of 53 non - repeated E. coli isolates from urine samples of pregnant women were presumptively identified using standard bacteriological method and confirmed by commercially available Microgen® Identification Kits. Phenotypic detection of ESBLs was determined using antibiotics susceptibility test and double disc synergy Method for screening and confirmation respectively. Polymerase Chain Reaction (PCR) was further used for the genotypic detection of ESBLs genes.Results: A total 88.67% (47/53) of E. coli exhibited resistance to the cephalosporins of which aztreonam was the highest (75.47%) and the least was cefpodoxime (35.84%) while 85.10% were confirmed positive for ESBL production. The genotypic detection showed the most occurring genotype was blaTEM (50%) blaOXA (27.7%), blaGES (22.5%), blaSHV (15%), blaCTXM and blaVEB (7.5%) while sixty – four (64%) of isolates co – harbored two or more gene. BlaTEM and blaOXA were dominant.Conclusion: This study showed high resistance of E. coli to the third generation cephalosporins harboring different ESBL genes which increases UTIs complexity and limit therapeutic options in pregnancy. Therefore, continuous monitoring of resistance in E. coli, effective appraisal of antibiotic control policies and rational use of antibiotics is therefore encouraged.


2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Anne CC Lee ◽  
Luke C. Mullany ◽  
Alain K. Koffi ◽  
Iftekhar Rafiqullah ◽  
Rasheda Khanam ◽  
...  

Abstract Background Urinary tract infection (UTI) in pregnancy, including asymptomatic bacteriuria, is associated with maternal morbidity and adverse pregnancy outcomes, including preterm birth and low birthweight. In low-middle income countries (LMICs), the capacity for screening and treatment of UTIs is limited. The objective of this study was to describe the population-based prevalence, risk factors, etiology and antimicrobial resistance patterns of UTIs in pregnancy in Bangladesh. Methods In a community-based cohort in Sylhet district, Bangladesh, urine specimens were collected at the household level in 4242 pregnant women (< 20 weeks gestation) for culture and antibiotic susceptibility testing. Basic descriptive analysis was performed, as well as logistic regression to calculate adjusted odds ratios (aOR) for UTI risk factors. Results The prevalence of UTI was 8.9% (4.4% symptomatic UTI, 4.5% asymptomatic bacteriuria). Risk factors for UTI in this population included maternal undernutrition (mid-upper arm circumference <23 cm: aOR= 1.29, 95% CI: 1.03–1.61), primiparity (aOR= 1.45, 95% CI: 1.15–1.84), and low paternal education (no education: aOR= 1.56, 95% CI: 1.09–2.22). The predominant uro-pathogens were E. coli (38% of isolates), Klebsiella (12%), and staphyloccocal species (23%). Group B streptococcus accounted for 5.3% of uro-pathogens. Rates of antibiotic resistance were high, with only two-thirds of E. coli susceptible to 3rd generation cephalosporins. Conclusions In Sylhet, Bangladesh, one in 11 women had a UTI in pregnancy, and approximately half of cases were asymptomatic. There is a need for low-cost and accurate methods for UTI screening in pregnancy and efforts to address increasing rates of antibiotic resistance in LMIC.


CJEM ◽  
2012 ◽  
Vol 14 (05) ◽  
pp. 295-305 ◽  
Author(s):  
Lyne Filiatrault ◽  
Rachel M. McKay ◽  
David M. Patrick ◽  
Diane L. Roscoe ◽  
Grahame Quan ◽  
...  

ABSTRACTIntroduction:We sought to determine the antibiotic susceptibility of organisms causing community-acquired urinary tract infections (UTIs) in adult females attending an urban emergency department (ED) and to identify risk factors for antibiotic resistance.Methods:We reviewed the ED charts of all nonpregnant, nonlactating adult females with positive urine cultures for 2008 and recorded demographics, diagnosis, complicating factors, organism susceptibility, and risk factors for antibiotic resistance. Odds ratios (ORs) and 95% confidence intervals (CIs) for potential risk factors were calculated.Results:Our final sample comprised 327 UTIs: 218 were cystitis, of which 22 were complicated cases and 109 were pyelonephritis, including 22 complicated cases.Escherichia coliaccounted for 82.3% of all UTIs, whereasStaphylococcus saprophyticusaccounted for 5.2%. In uncomplicated cystitis, 9.5% of all isolates were resistant to ciprofloxacin and 24.0% to trimethoprim-sulfamethoxazole (TMP-SMX). In uncomplicated pyelonephritis, 19.5% of isolates were resistant to ciprofloxacin and 36.8% to TMP-SMX. In UTI (all types combined), any antibiotic use within the previous 3 months was a significant risk factor for resistance to both ciprofloxacin (OR 3.34, 95% CI 1.16–9.62) and TMP-SMX (OR 4.02, 95% CI 1.48–10.92). Being 65 years of age or older and having had a history of UTI in the previous year were risk factors only for ciprofloxacin resistance.Conclusions:E. coliwas the predominant urinary pathogen in this series. Resistance to ciprofloxacin and TMP-SMX was high, highlighting the importance of relevant, local antibiograms. Any recent antibiotic use was a risk factor for both ciprofloxacin and TMP-SMX resistance in UTI. Our findings should be confirmed with a larger prospective study.


2018 ◽  
Vol 6 (2) ◽  
pp. 13-20 ◽  
Author(s):  
K. L. Lokshin ◽  
V. N. Shirshov ◽  
A. S. Popko ◽  
Yu. L. Demidko ◽  
N. D. Luchenkova

Introduction.The main treatment component of asymptomatic bacteriuria, acute cystitis and pyelonephritis in pregnant women is antibiotic therapy, which in many patients is prescribed empirically. For successful selection of the drug, it is necessary to know both the structure of pathogens and the current profile of their antibiotic resistance.Purpose of research.The study of species composition and resistance to antibiotics of bacteria that cause urinary tract infections (UTIs) in pregnant women in the Moscow RegionMaterials and methods.The study included 104 pregnant women with uncomplicated UTIs who were observed and treated at the Lapino Clinical Hospital between 2016 and 2017. The material for bacteriological studies was the midstream portion of urine or urine collected by a catheter.Results.90 patients had asymptomatic bacteriuria, 10 had acute cystitis, and 4 had acute gestational pyelonephritis. The structure of the pathogens of UTI is presented: E. coli, Enterococcus faecalis, Klebsiella pneumoniae, Proteus spp., Staphylococcus spp., Streptococcus spp., Enterobacter cloacae. The most frequently detected pathogens were E. coli (67.3%) and E. faecalis (50%). Resistance rate of E.coli strains more than 20% was detected to ampicillin (36.4%), amoxicillin / clavulanate (23.2%), trimethoprim / sulfamethoxazole (27.4%), nalidixic acid (20.7%), cephalosporins 2 and 3 generation (respectively, 25.7% and 24.3%). Resistance rate more than 20% in Enterobacteriaceae family strains was detected to trimethoprim/sulfamethoxazole (24.4%), nalidixic acid (20.7%), cephalosporins 2 generations (21.7%). Antibiotic resistance of E.coli and other Enterobacteriaceae family taxons less than 10% was noted only with respect to carbapenems (0%) and fosfomycin (1.5% and 3.5%, respectively).Conclusions.It is expedient to use the obtained data on the composition and sensitivity profile of uropathogens in UTIs in pregnant women when choosing starting empirical antibiotic therapy. Disclosure: The study did not have sponsorship. The authors have declared no conflicts of interest.


Author(s):  
Srinath M. P. ◽  
Shajina M. ◽  
Fasalu Rahiman O. M.

Background: Infectious disease such as urinary tract infection was found very commonly during all pregnancies. Chronic renal failure, pyelonephritis, preeclampsia, anemia, fetal mortality and premature delivery are the common complication associated with UTI in pregnancy. Hence the management and prevention of UTI in pregnancy is the crucial factor for the sustained pregnant period. It is more important for a clinician to recognize the pathogenic factor for UTI and its sensitivity profile for planning an effective treatment for infected patients. Hence the present study was designed to identify the pathogenic agents of UTI among pregnant women and to find out the drug susceptibility patterns of the isolated organism against commonly prescribed antibioticsMethods: A prospective analysis was carried out by collecting urine from the 210 patients, the sample was also processed for antimicrobial drug susceptibility testing.Results: A positive report was seen in 26 cases with 13.4% of incident rate. Escherichia coli 14 (53.8%), Klebsiella species 23.07%, Enterococcus species 7.69%, Staphylococcus aureus 3.84%, Proteus 3.84%, Pseudomonas aeroginosa 3.84%, Streptococcus pyogenes 3.84% were the most common isolate found in the present population. The isolated pathogens were sensitive to Ceftazidime, Cefotaxime, Ciprofloxacin, Gentamicin, and Amikacin.Conclusions: It is there for recommended that routine microbiological analysis and antibiotic sensitivity test of urine samples of pregnant women must be carried out before the administration of drugs for better treatments and managements of urinary tract infection.


1989 ◽  
Vol 34 (6) ◽  
pp. 561-563 ◽  
Author(s):  
F. D. Johnstone ◽  
L.R. McCallum ◽  
R.P. Brettle ◽  
S.M. Burns ◽  
J. F. Peutherer

Since HIV testing became available in Edinburgh in September 1985, testing in pregnancy has been offered (after counselling and with informed consent) on a selective or case finding basis. This study reviews the results of the first three years for all Edinburgh city hospitals. HIV serostatus was known for 436 such pregnant individuals during this time, and 79 women were known to be infected with HIV. There was little change in the number of first tests done in pregnancy, a decline in the number of women discovered during pregnancy to be seropositive, and a corresponding increase in women referred known to be HIV infected. With one exception, all seropositive women gave a history of injecting drug use or having a steady drug using sexual partner known to be HIV seropositive. Forty-five per cent of pregnant women with the former risk, and 16% of pregnant women with the latter risk were HIV seropositive. The minimum prevalence of HIV infection for women domiciled in Edinburgh city was approximately 0.4% of pregnancies, with a higher prevalence in women having induced abortion and a lower prevalence in continuing pregnancies. However, HIV serostatus was known in only 1.6% of all pregnancies. HIV infection in pregnant Edinburgh women may be confined largely to a cohort of injection drug users and sexual partners of infected male drug users but total population prevalence data are urgently required.


2020 ◽  
Author(s):  
◽  
John Edward Munyaga ◽  
David Serunjogi

Background: Proteinuria refers to a condition where more than trace amounts of proteins are found in normal urine. Proteinuria is a defining dysfunction of pre-eclampsia Proteinuria is one of the cardinal indications of pre-eclampsia, a common and severe complication in pregnancy. Also, there are several factors responsible for its occurrence among pregnant women. The study aimed to establish the occurrence of proteinuria among pregnant women and to establish the predisposing factors of proteinuria among pregnant women attending antenatal care services in St. Francis Hospital Nsambya. Methodology:  This was a cross-sectional study where qualitative and quantitative data was collected. Participants’ urine samples were taken off and analysed macroscopically, protein detection using uristics, and 25% SSA and then microscopic examination done once they had consented. Results:  Out of 96 participants, the occurrence of proteinuria was 9.4% (p = 0.094) and it was increasing with the increase in the age of the pregnant women. The predisposing factors to proteinuria in pregnancy were urinary tract infections (88.9%) (p = 0.889), hypertension (11.1%) (p = 0.111) and gestation age.  Conclusion and recommendation:  Clients who receive antenatal care services in St. Francis Hospital Nsambya antenatal clinic should routinely be screened for proteinuria. Wider research about proteinuria among pregnant women should be done to establish a more nationalistic occurrence. Health education should emphasize the importance of pregnant women reporting urinary tract infections after being empowered with its signs and symptoms even without pain. This is because urinary tract infections can lead to complications in pregnancy and could become fatal.


Author(s):  
L. Lebid

the review contains information about modern conception of the urinary tract infections in pregnant women, the scheme of treatment and prevention of relapse in view of topical diagnosis and category of the teratogenicity of drugs on the criteria of FDA


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