Multidrug Resistant Uropathogens among Egyptian Pregnant Women

Abstract

Urinary Tract Infections (UTIs) in pregnancy is a common medical problem associated with significant increase in the risk of fetal morbidity and mortality. The effective appropriate antimicrobial agent is a major concern as many effective antimicrobial groups cannot be used due to their potential toxicity to the fetus as well as the increasing rates of Multidrug-Resistant (MDR) strain isolation. This crosssectional study was conducted on women attending the antenatal care of Zagazig University. This study aimed to estimate prevalence of various uropathogens in UTI among the pregnant women and determine their antimicrobial resistance patterns. Clean catch mid-stream urine samples were obtained, complete microbiological examination and antibiotic susceptibility testing were carried out. More than half of culture positive samples was obtained from asymptomatic pregnant women. Asymptomatic bacteriuria was more common among primigravida, women of low socioeconomic class and with history of previous Cesarean section. Gram negative bacterial isolates were the most prevalent (71%). The most frequently isolated pathogens were: E. coli 34%, K. pneumoniae 26% and S. saprophyticus 23%, among the total Gram negative isolates, 95.0% were MDR. Meropenem was the antibiotic with the highest susceptibility rate (96%) on E coli isolates, followed by nitrofurantoin (74%) and tobramycin (72%). Recommendations: Urine culture and sensitivity must be the role as MDR pathogens are increasing, rationalization of antibiotic administration is a must.

Molecular characterization of carbapenem resistant Gram-negative rods in Neonatal Intensive Care Unit of Mansoura University Childrens Hospital

“…pneumoniae (37.9%) was the most common CR species isolated followed by E. coli (24.1%). This is in agreement with other CR studies in Egypt, United States, Europe and China (Metwally and Elnagar, 2019;Centers for Disease Control and Prevention, 2013;Akova et al, 2012;Yang et al, 2018) and is consistent with the CDC's recommendations that K. pneumoniae, E. coli, and Enterobacter spp. are the key health care-associated pathogens to focus on in the control of US CR epidemic (Centers for Disease Control and Prevention, 2014).…”

Prevalence and antimicrobial resistance patterns of nosocomial pathogens causing Surgical Site Infections in an Egyptian University hospital.

“…Among the tested antimicrobial agents, carbapenems and aminoglycoside were the most effective options, this finding is similar to those of Chaudhary et al [16]. Pervious study had indicated that Gram negative uropathogens exhibited excellent sensitivity to meropenem and aztreonam [24]. This study showed that 65.8% of Gram-negative bacteria were confirmed to be ESBL producer by combined disc test, this comes in accordance with some studies [14,25], lower rates were reported in other studies [24,26].…”

“…Lower rates were reported in some studies [16,31]. Other Egyptian studies showed variable isolation rates of MDR ranging from 37.2 to 95%, with observed chronologically increasing rates [14,24,32].…”

In vitroassessment of the antibacterial effects of the combinations of fosfomycin, colistin, trimethoprim and nitrofurantoin against multi‐drug–resistantEscherichia coli

“…Moreover, UTI was more frequent (70%) among full-term neonates (Mohamed et al 2020). Escherichia coli is the most common etiologic agent and the most widespread cause (75-95%) of UTI worldwide (Lee and Le 2018;Metwally and Elnagar 2019;Prasada et al 2019;Bazzaz et al 2021). Several studies from Egypt revealed that the most frequent microorganisms causing UTI were E. coli (30Á7-74%), followed by Staphylococcus aureus (17Á5À21Á1%) and Klebsiella spp.…”