Bacterial resistance in urine cultures in a population of pregnant women in prenatal care in Bogotá june 2013 – june 2015
DOI:
https://doi.org/10.18041/2390-0512/biociencias.2.5003Keywords:
Pregnancy, Urinary Tract Infections, Bacteriuria, Drug resistance, bacterial, Anti-bacterial AgentsAbstract
Urinary tract infection (UTI), specifically asymptomatic bacteriuria, affects 2% to 7% of pregnancies; without treatment, it evolves into pyelonephritis, increases the probability of preterm birth, low birth weight and preeclampsia. Detection and treatment of UTI is a priority. Knowing the antibiotic sensitivity of different pathogens allows us to review treatment strategies and reduce adverse perinatal outcomes. Objective: To determine the resistance profile of the main pathogens isolated in urine cultures of pregnant patients who attended prenatal care in Clinica Colsanitas. Materials and Methods: An observational study was performed with pregnant patients who attended prenatal care. All urine culture results were taken from the pregnant patients and urine cultures suggestive of contamination were excluded. The isolated pathogens and the sensitivity to the different antibiotics were analyzed. Results: Out of 14054 urine samples, 1177 were positive. The main isolated pathogen was Escherichia coli with a prevalence of 71.4%, followed in frequency by Enterococcus faecalis, Proteus mirabilis and Klebsiella pneumoniae. The resistance of Escherichia coli to ampicillin was 37.3%, trimethoprim sulfamethoxazole 23.3%, cefalotin 11.1%. The sensitivity to fosfomycin was 98%. In general, the most frequently isolated pathogens showed low rates of beta-lactamase expression. Conclusions: E. coli was the most frequent pathogen. The high resistance to ampicillin contraindicates its empirical use. The use of other antibiotics such as cephalexin or nitrofurantoin is adequate. Fosfomycin may be an option when it is not possible to use previously described.
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References
2. Fiadjoe P, Kannan K, Rane A. Maternal urological problems in pregnancy. European Journal of Obstetrics & Gynecology and Reproductive Biology 152 (2010) 13–17
3. Casas-P R, Ortiz M, Erazo-Bucheli D. Prevalencia de la resistencia a la ampicilina en gestantes con infección urinaria en el Hospital Universitario San José de Popayán (Colombia) 2007-2008. Revista Colombiana de Obstetricia y Ginecología Vol. 60 No. 4 • 2009 • (334-338)
4. Meher R, Khan F, Shukla I, Malik A. Rising Prevalence of Antimicrobial Resistance in Urinary Tract Infections During Pregnancy: Necessity for Exploring Newer Treatment Options. Journal of Laboratory Physicians / Jul-Dec 2011 / Vol-3 / Issue-2.
5. Mittal P, Wing DA. Urinary Tract Infections in Pregnancy. Clin Perinatol 32 (2005) 749– 764
6. Eigbefoh JO,Isabu P, Okpere E, Abebe J. The diagnostic accuracy of the rapid dipstick test to predict asymptomatic urinary tract infection of pregnancy. Journal of Obstetrics and Gynaecology, July 2008; 28(5): 490–495.
7. Lumbiganon P, Laopaiboon M, Thinkhamrop J. Screening and treating asymptomatic bacteriuria in pregnancy. Curr Opin Obstet Gynecol 2010; 22:95–9
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. Pais P, Khurana R, George J. Urinary tract infections: a retrospective survey of causative organisms and antibiotics prescribed in a tertiary care setting. Indian J Pharmacol 2002;34:278-80.
10. Reyes A, Gómez A, Rodriguez J. Validez del parcial de orina y el gram en el diagnóstico de infección del tracto urinario en el embarazo. Hospital Simón Bolívar, Bogotá, Colombia, 2009-2010. Revista Colombiana de Obstetricia y Ginecología Vol. 64 No. 1 • 2013 • (53-59)
11. Ferreira F, Olaya S, Zuñiga P, Angulo M. Infección urinaria durante el embarazo, perfil de resistencia bacteriana al tratamiento en el Hospital General de Neiva, Colombia. Revista Colombiana de Obstetricia y Ginecología. Vol. 56 No. 3 . 2005. (239-243).
12. Pinto E. Antimicrobial agents resistance in Chile nowadays. Rev Chil Infectol 2002; 19 Suppl 3:S213-S218
13. Taneja N, Rao P, Arora J, Dogra A. Occurence of ESBL and Amp-C-β-lactamases and susceptibility to newer antimicrobial agents in complicated UTI. Indian J Med Res 2008;127:85-8
14. Jolley JA, Wing DA. Pyelonephritis in Pregnancy An Update on Treatment Options for Optimal Outcomes. Drugs 2010; 70 (13): 1643-1655
15. Martinez E, Osorio J, Delgado J, Esparza G.E.. Infecciones del tracto urinario bajo en adultos y embarazadas: consenso para el manejo empírico. Infectio 2013;17(3):122-135
16. Rubin RH, Beam TR, Stamm WE. An approach to evaluating antibacterial agents in the treatment of urinary tract infection. Clin Infect Dis 1992;14 Suppl 2:S246-51.
17. Collee JG, Fraser AG, Marmion BP, Mackey SA, McCartney. Practical Medical Microbiology. In: Collee JG, Miles RS, Watt B, editors. Tests for the identification of Bacteria. 14th ed. New Delhi, India: Elsevier; 2006. p. 131-49
