Prevalence, Clinico-Bacteriological Profile, and Antibiotic Resistance of Symptomatic Urinary Tract Infections in Pregnant Women

Abstract

Background: Urinary tract infection (UTI) is a common complication in pregnancy. The prevalence varies between countries. This research aims at estimating the prevalence, clinico-bacteriological profile, antibiotic resistance, and risk factor analysis of symptomatic UTI in pregnancy. Method: This is a prospective observational study conducted at the Abdullah Bin Omran Hospital, RAK, UAE, from March 2019 to February 2020. All pregnant women attending the antenatal clinic during this period were given a pre-validated questionnaire for the symptoms of UTI. In symptomatic patients, urine was sent for microscopy, culture, and sensitivity. Women were treated for UTI and were followed up for the rest of the pregnancy. Data analysis was performed by SPSS software version 24 using descriptive statistics and comparisons with significance at a p-value of <0.05. Results: The prevalence of symptomatic UTI was 17.9%. E.coli was the commonest isolate followed by Group B streptococcus. The commonest symptom reported was loin pain and the most common risk factor was diabetes. Women with risk factors are significantly more likely to have culture-positive UTIs. Most of the pathogens were sensitive to cefuroxime and benzyl penicillin. Risk of preterm labor was higher. Conclusions: Regular antenatal care and routine urine testing in all visits are recommended for early detection and treatment of UTI.

Comparative Analysis of Microbial Species and Multidrug Resistance Patterns Associated with Lower Urinary Tract Infections in Preterm and Full-Term Births

“…Similar to our study, E. coli is the most commonly isolated pathogen in different studies, but with relatively different prevalences, as low as 27% in Dube’s et al study [ 26 ], compared with other studies [ 28 , 29 ], while the prevalence of GBS and K. pneumoniae is reported in higher prevalence in other research [ 28 , 30 ]. Even though we identified only 3.6% of Staphylococcus isolates, in the UAE study, no cultures identified Staphylococcus spp.…”

“…Considering that the current study used a monocentric database, it is important to acknowledge geographical and population-based differences in terms of UTIs. For example, one study from UAE found around 37% of pregnant symptomatic patients with UTI not exhibiting any growth of uropathogens in their urine [ 26 ], a proportion exceeding that reported in some other research [ 27 ]. However, in our study we excluded the negative samples to better determine antibiotic resistance patterns and MDR.…”

“…Even though we identified only 3.6% of Staphylococcus isolates, in the UAE study, no cultures identified Staphylococcus spp. [ 26 , 31 ]. Therefore, it can be assumed that the local microbial profile, including the predominance of E. coli in recurrent UTIs, likely reflects geographical and sociocultural influences.…”

Knowledge, Attitudes, and Practices Regarding Urinary Tract Infections Among Women in the United Arab Emirates

“…One of the reasons attributable to this fact is the presence of shorter urethra in women, which makes it easier for bacteria or other microbes to reach the bladder or urinary tract and cause infection [1, 3]. It is estimated that approximately 60% of females experience at least one UTI in their lifetime [3], which is more likely to occur in menopausal or pregnant women [3-4]. The urinary system is designed to keep the foreign bacteria out, but sometimes, failure of host defenses to remove these bacteria can result in UTIs.…”

“…Despite being preventable, UTIs are quite prevalent among women in the UAE [4]. They can be prevented by staying well-hydrated, maintaining hygiene, urinating after sexual activity, and raising awareness among girls and women [1, 6].…”