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Urinary tract infection in pregnancy

Author(s): José Metello

Journal: Acta Obstetrica e Ginecologia Portuguesa
ISSN 1646-5830

Aim: Urinary tract infections (UTI) are the most common bacterial infections in pregnancy, affecting nearly 20% of pregnancies and causing about 10% of hospital admissions.Objective: To identify and compare infeccious agents and antibiogram results of all UTI in the pregnant population of a terciary care maternity hospital. To compare UTI agents from patients in the outpatient clinic and in the hospital wards. To establish guidelines for antibiotic administration because of UTI during pregnancy.Methods: Retrospective eveluation of all urinary cultures requested at the hospital between 2005 and 2006. Results were analysed separately for outpatients and inpatients. A total of 3487 cultures were included in the study, of which 402 had an isolated agent. E. coli was isolated in 55.2% of outpatients vs. 60.2% of inpatients. For Streptococcus agalactiae the proportion was 16.7% vs. 5.5%, for P. mirabilis 9.4% vs. 6.4%, and for K. pneumoniae 7.7% vs. 3.8%. Antibiotic resistance for ampiciline was 53.8% vs. 62.6%; for amoxi-clavulanate 18% vs. 43.6%; for co-trimoxazol 15.3% vs. 19.5%; for nitrofurantoin 17.8% vs. 14.6%; for cephalotin 31.1% vs. 46.4%; and for cefuroxime 3.1% vs. 5.3%.Conclusion: The most frequent UTI agent, in both outpatient and inpatient settings, was E. coli. In inpatients ampicilin, cephalotin, and amoxi-clavulanate showed high rates of resistance. This study suggests that in women admitted with complicated UTI the first treatment option should be cefuroxime.
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