Antibiotics Dispensed to Privately Insured Pregnant Women with Urinary Tract Infections — United States, 2014

Ailes, Elizabeth C.; Summers, April D; Tran, Emmy L; Gilboa, Suzanne M.; Arnold, Kathryn E.; Meaney‐Delman, Dana; Reefhuis, Jennita

doi:10.15585/mmwr.mm6701a4

Cited by 34 publications

(30 citation statements)

References 10 publications

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“…A recent report from the US found that 7.2% of pregnant women had a diagnosis of UTI. Nitrofurantoin and beta‐lactams including cephalosporins (such as cephalexin) and penicillins (such as amoxicillin) were the most commonly dispensed antibiotics for this group of patients …”

Section: Introductionmentioning

confidence: 99%

“…Nitrofurantoin and beta-lactams including cephalosporins (such as cephalexin) and penicillins (such as amoxicillin) were the most commonly dispensed antibiotics for this group of patients. 2 Considerable attention has focused on antimicrobial resistance (AMR) as there is evidence suggesting that AMR incidence is increasing in both high-and low-income countries. The issue of high level of AMR is well illustrated by the most recent surveillance report in 22 countries declared by the World Health Organization (WHO) 3 which reported Escherichia coli (E coli) and Klebsiella pneumoniae (K pneumoniae) as the two most common resistant bacteria.…”

Section: Introductionmentioning

confidence: 99%

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Extended‐spectrum beta‐lactamase (ESBL)‐producingEnterobacteriaceaeand urinary tract infections in pregnant/postpartum women: A systematic review and meta‐analysis

et al. 2019

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Background Urinary tract infections (UTI) and asymptomatic bacteriuria (AB) during pregnancy can result in considerable maternal and foetal adverse outcomes. Production of extended‐spectrum beta‐lactamase (ESBL) is a major antibiotic resistance mechanism by Enterobacteriaceae. Objectives To determine the global prevalence of ESBL‐producing (ESBL‐P) Enterobacteriaceae in symptomatic UTI/AB among pregnant/postpartum females. Data sources A systematic review of the PubMed, Embase, Scopus, WOS (Web of Science), ProQuest and the grey literature was conducted. Study selection and data extraction Studies that reported the frequency of ESBL‐P Enterobacteriaceae in pregnant/postpartum women with UTI and/or AB were eligible. First, the titles and abstracts of the retrieved articles were reviewed. Then, the full texts of the remained articles were reviewed. Synthesis In order to estimate the pooled prevalence and the 95% confidence interval (95% CI), meta‐analysis was performed using the random‐effects model. Results Twenty‐three studies (six from Africa, two from North America, one from South America, 12 from Asia and two European studies) that reported data on 20 033 Enterobacteriaceae strains were included. The pooled prevalence of ESBL‐P Enterobacteriaceae was 25% (95% CI 18%, 32%); I2 = 98.8%. The estimated prevalence (95% CI) rates were 45% (22, 67%) in Africa, 33% (22, 44%) in India, 15% (6, 24%) in other Asian countries, 5% (2, 8%) in Europe, 4% (1, 11%) in South America and 3% (1, 5%) in North America (P < .001). This estimate was 21% (95% CI 11, 31%) in patients with symptomatic UTI and it was 28% (95% CI 15, 41%) in patients with AB (P = .40). Conclusions The prevalence of ESBL‐P Enterobacteriaceae among pregnant women with UTI/AB was significant and geographic region was a major source for heterogeneity. The findings could be taken into account by healthcare providers and programmers in the management and antibiotic selection of UTI/AB during pregnancy, especially in high prevalence areas.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Extended‐spectrum beta‐lactamase (ESBL)‐producingEnterobacteriaceaeand urinary tract infections in pregnant/postpartum women: A systematic review and meta‐analysis

et al. 2019

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“…Pregnant women are typically screened for urinary tract infections (UTIs) in early pregnancy and those with bacteriuria are treated with antibiotics [1]. Its accurate and prompt diagnosis plays an important role in reducing the course of the disease by preventing renal failure following the ascent of the infection in the upper urinary tract [2].…”

Section: Introductionmentioning

confidence: 99%

Pathogenic features of urinary Escherichia coli strains causing Asymptomatic Bacteriuria during Pregnancy

Mohebi

Hashemizade

Hadadi

et al. 2020

Preprint

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Background Asymptomatic bacteriuria is one of the common problems in pregnancy. Pyelonephritis, preterm labor and low birth weight infants have been associated with bacterial infection. Urinary tract infection (UTI) during pregnancy is frequently associated with complications. An observational cross-sectional study including investigated the prevalence of virulence genes, antimicrobial resistance, and its relationship with phylogenetic groups among E. coli strains isolated from pregnant women with asymptomatic bacteriuria who referred to Hafez hospital, Shiraz, Iran. Material and Methods A total of 300 urine samples were screened for Escherichia coli strains. Susceptibility testing was determined by the disk-diffusion method. The phylogenetic groups and 13 virulence genes were identified by PCR. ESBL and AmpC producing isolates were detected using phenotypic methods. PCR was used to identify the bla TEM , bla SHV and bla CTXM genes in ESBL and AmpC-positive isolates. Results Our results revealed that among 300 urine samples, 105 (35%) were positive for E. coli . The data showed that the highest and the lowest resistance rates were observed against nalidixic acid (82.1%), and imipenem (2.8%), respectively. The prevalence of ESBLs and AmpC-β-lactamase, in the E. coli isolates was 41% and 9.5% respectively. bla CTXM was the commonest genotype (93%). Phylogenetic group distribution was as follow: B1 2.8%, A 14.2%, B2 61.9%, and D 4.6%. Our result showed that most of the virulence genes belonged to group B2 and also several virulence genes such as hlyA , cnf-1 , and papGII genes were positively associated with group B2. Conclusion Among E. coli strains isolated from patients with UTIs, different features phylogroups, with special virulence factors, could cause severe infection. Awareness about the Virulence patterns distribution among Phylogenetic groups of UPEC could greatly aid in confine and prevent the development of lethal infection caused by these strains.

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“…Around 20-30% of women with a first UTI will have recurring infections [1]. UTIs in pregnancy occurs in almost 8% of pregnant women, and without treatment, UTIs can have severe consequences for the mother as well as the unborn child, including pyelonephritis,, low birth weight, preterm delivery and sepsis [2]. Most recurrences are reinfections, caused by the introduction of a new microorganism from the fecal/perineal flora into the urinary tract.…”

Section: Introductionmentioning

confidence: 99%

Evaluating the prevalence of plasmid- mediated quinolone resistant and ESBL- production in Uropathogenic Escherichia coli and the commensal gut microbiota in pregnant women: A comparative analysis

Mohebi¹,

Kholdi²,

Hadadi³

et al. 2020

Preprint

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Background: ß-lactam and ﬂuoroquinolone antibiotics are frequently prescribed for urinary tract infections (UTIs). This study aimed to determine the prevalence of plasmid-mediated quinolone resistance (PMQR) and extended spectrum β-lactamases (ESBLs) in E. coli from UTIs in comparison with the E. coli isolates from gut microbiota (fecal flora).Methods: A total of 54 E. coli urine isolates and 54 E. coli fecal flora isolates were collected from pregnant women (same host) from April to September 2018. Antimicrobial susceptibility testing was determined by disk diffusion method. ESBLs were detected via double-disk test (DDST). ESBL and PMQR-encoding genes were identified, using PCR.Results: The highest resistance rate was found against nalidixic acid (42 isolates in urinary and 41 in fecal flora isolates) and the lowest resistance rate belonged to levofloxacin (23 isolates) and ofloxacin (25 isolates) in urinary and fecal flora isolates. The most prevalent PMQR genes were qnrS (29 isolates in urinary and 34 in fecal flora isolates) followed by qnrB, aac (6′)- Ib-cr and qnrA in urinary and fecal flora isolates. There was a significant association between qnrS gene and blaTEM in urinary and fecal flora isolates.Conclusions: Resistance to quinolones antibiotics was highest among fecal flora isolates, especially qnrS among other determinants of the qnr gene. In addition, it seems that high load of PMQR genes in commensal flora has a potential to spread to pathogenic organisms.

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Antibiotics Dispensed to Privately Insured Pregnant Women with Urinary Tract Infections — United States, 2014

Cited by 34 publications

References 10 publications

Extended‐spectrum beta‐lactamase (ESBL)‐producingEnterobacteriaceaeand urinary tract infections in pregnant/postpartum women: A systematic review and meta‐analysis

Extended‐spectrum beta‐lactamase (ESBL)‐producingEnterobacteriaceaeand urinary tract infections in pregnant/postpartum women: A systematic review and meta‐analysis

Pathogenic features of urinary Escherichia coli strains causing Asymptomatic Bacteriuria during Pregnancy

Evaluating the prevalence of plasmid- mediated quinolone resistant and ESBL- production in Uropathogenic Escherichia coli and the commensal gut microbiota in pregnant women: A comparative analysis

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