Keywords
Urinary infection
Uropathogens
Susceptibility profile
How to Cite
Copyright © | All rights reserved.
The journal holds the exclusive copyright for the publication of this article under the terms of Brazilian law 9610/98.
Partial reproduction
The use of parts of the texts, figures and questionnaire of the article is free, being mandatory the citation of the authors and journal.
Total reproduction
It is expressly prohibited and must be authorized by the journal.
Abstract
Objective: To determine the antimicrobial susceptibility profile of uropathogens in pregnant women attended at a laboratory located in the western region of Bahia. Methods: A retrospective, cross-sectional, and descriptive study was conducted with 1.317 pregnant women undergoing urine culture and antibiogram from January 2013 to December 2023. Data were collected encompassing sociodemographic variables, healthcare variables, and clinical-pathological characterization. All samples with bacterial growth ≥10⁵ CFU/mL were included. Positive results for fungal growth were excluded. Frequencies of variables were determined, and the Chi-square test was applied to assess associations. Results: Approximately 70,8% showed bacterial growth. Among these, 60,8% were in the age group of 21 to 30 years, 93,5% reported infection before pregnancy, 57,2% had recent treatment for urinary tract infection, 29,8% presented recurrence of infection during pregnancy, and 34,9% had comorbidities. In addition, 54,1% were diagnosed in the 1st trimester, with 84,3% being asymptomatic. E. coli (45,9%), Klebsiella sp. (11,4%), and E. faecalis (9,1%) were the main identified etiological agents. Conclusion: The high incidence of these conditions highlights the importance of monitoring, emphasizing early identification, especially in the 1st trimester, underscoring the relevance of surveillance even in asymptomatic cases.
References
ARRUDA RM, et al. Alternativas aos antibióticos na profilaxia das infecções urinárias recorrentes não complicadas na mulher. Revista Femina, 2022; 50(9): 572-576.
BETSCHART C, et al. Guideline of the Swiss Society of Gynaecology and Obstetrics (SSGO) on acute and recurrent urinary tract infections in women, including pregnancy. Swiss Med Wkly, 2020; 150: w20236.
BRASIL. Ministério da Saúde. Secretaria de Atenção Primária à Saúde. Departamento de Ações Programáticas. Manual de gestação de alto risco [recurso eletrônico] / Ministério da Saúde, Secretaria de Atenção Primária à Saúde. Departamento de Ações Programáticas. – Brasília: Ministério da Saúde, 2022.
CARVALHO RSS, et al. Análise do manejo de infecções do trato urinário na gestação. Revista Eletrônica Acervo Saúde. 2023; 23(2): e11778.
CASTRO D, et al. Pielonefrite aguda na gravidez complicada por síndrome de dificuldade respiratória aguda - A propósito de dois casos clínicos. Acta-Obstet-Ginecol-Port. 2015; 9(2): 174-178.
COMIN D, et al. Prevalência de infecção do trato urinário e perfil de sensibilidade bacteriana aos antimicrobianos prescritos para gestantes do hospital escola de valença. Revista Saber Digital, 2020; 13(1): 70-86.
DA LUZ VITÓRIA R, et al. Investigação de atendimento à gestantes diagnosticadas com cistite/infecções urinárias em pré-natal de alto risco numa cidade do interior da Bahia. The Brazilian Journal of Infectious Diseases. 2023; 1(27): 103187.
DA SILVA LB e DE SOUZA PGVD. Infecção do trato urinário em gestantes: uma revisão integrativa. Research, Society and Development. 2021; 10(14): e446101422168.
DE ABREU SILVA R, et al. Infecção Do Trato Urinário Na Gestação: Diagnóstico e Tratamento. Revista Científica FAEMA. 2019; 10(1): 71–80.
DE ARAÚJO CQL, et al. Fatores de risco associados à Infecção do Trato Urinário (ITU) em mulheres: uma revisão integrativa de literatura. Research, Society and Development. 2021; 10(12): e402101220567.
DE ROSSI P, de et al. Joint report of SBI (Brazilian Society of Infectious Diseases), FEBRASGO (Brazilian Federation of Gynecology and Obstetrics Associations), SBU (Brazilian Society of Urology) and SBPC/ML (Brazilian Society of Clinical Pathology/Laboratory Medicine): recommendations for the clinical management of lower urinary tract infections in pregnant and non-pregnant women. Braz. J. Infect. Dis. 2020; 24(2): 110-119.
DEMILIE T, et al. Urinary Bacterial Profile and Antibiotic Susceptibility Pattern Among Pregnant Women in North West Ethiopia. Ethiopian Journal of Health Sciences. 2012; 22(2): 121-8.
DUANE S, et al. COSUTI: a protocol for the development of a core outcome set (COS) for interventions for the treatment of uncomplicated urinary tract infection (UTI) in adults. Trials. 2019; 20(1):106-132.
FALAVINA LP, et al. Hospitalização durante a gravidez segundo financiamento do parto: um estudo de base populacional. Revista da Escola de Enfermagem. 2018; 52: e03317.
FLORES-MIRELES A, et al. Pathophysiology, treatment, and prevention of catheter-associated urinary tract infection. Topics in Spinal Cord Injury Rehabilitation. 2019; 25(3): 228–240.
FREITAS PMC, et al. Infecção do trato urinário em gestantes: Possíveis causas. Brazilian Journal of Implantology and Health Sciences. 2023; 5(3): 270-283.
GUPTA JK, et al. Position in the second stage of labour for women without epidural anaesthesia. Cochrane Database Syst Rev. 2017; 25(5): CD002006.
GUERRA GVQL, et al. Exame simples de urina no diagnóstico de infecção urinária de alto risco. Revista Brasileira de Ginecologia e Obstetrícia. 2012; 34(11): 488-493.
HAIDER G, et al. Risk factors of urinary tract infection in pregnancy. JPMA. The Journal of the Pakistan Medical Association. 2010; 60(3): 213-216.
HAMDAN ZH, et al. Epidemiology of urinary tract infections and antibiotics sensitivity among pregnant women at Khartoum North Hospital. Annals of Clinical Microbiology and Antimicrobials. 2011; 10(2): 2011.
KHALESI MDN, et al. Avaliação da infecção do trato urinário materno como potencial fator de risco para a infecção neonatal do trato urinário. J Family Reprod Health. 2014; 8(2):59-62.
LEE AC, et al. Urinary tract infections in pregnancy in a rural population of Bangladesh: population-based prevalence, risk factors, etiology, and antibiotic resistance. BMC Pregnancy Childbirth. 2019; 20(1): e90734562.
MALEKZADEGAN Y, et al. Distribution of virulence genes and their association with antimicrobial resistance among uropathogenic Escherichia coli isolates from Iranian patients. BMC infectious diseases. 2018; 18(1): 1-9.
MARQUES BOB, et al. As consequências da infecção do trato urinário durante o período gestacional. Revista Eletrônica Acervo Saúde. 2023: 23(1): e11387.
MARQUES BL, et al. Orientações às gestantes no pré-natal: a importância do cuidado compartilhado na atenção primária em saúde. Escola Anna Nery. 2021; 25(1): e20200098.
MATUSZKIEWICZ-ROWIŃSKA J, et al. Urinary tract infections in pregnancy: old and new unresolved diagnostic and therapeutic problems. Arch Med Sci. 2015;11(1): 67-77.
MEDINA M, e CASTILLO-PINO E. An introduction to the epidemiology and burden of urinary tract infections. Therapeutic Advances in Urology. 2019; 11(2): 3-7.
NGONG IN, et al. Prevalence, antimicrobial susceptibility pattern and associated risk factors for urinary tract infections in pregnant women attending ANC in some integrated health centers in the Buea Health District. BMC Pregnancy Childbirth. 2021; 21(1): 2-14.
NTEZIYAREMYE J, et al. Asymptomatic bacteriuria among pregnant women attending antenatal care at Mbale Hospital, Eastern Uganda. PLoS One. 2020; 15(3): 1–12.
OLIVEIRA RA, et al. Perfil de suscetibilidade de uropatógenos em gestantes atendidas em um hospital no sudoeste do estado do Pará, Brasil. Rev Pan-Amaz Saude. 2016; 7(3): 43-50.
RAMOS GC, et al. Prevalência de infecção do trato urinário em gestantes em uma cidade no Sul do Brasil. Saúde Santa Maria. 2016; 42(1):173-178.
RASOOL MS, et al. Prevalence and antibiotic resistance profiles of Gram-negative bacilli associated with urinary tract infections (UTIs) in Karachi, Pakistan. Pakistan journal of pharmaceutical sciences. 2019; 32(6): 22-35.
ROSENTHAL ST, et al. Urinary tract infection-epidemiological, physiopathological aspects and therapeutic management. Brazilian Journal of Development. 2022; 8(7): 52571-52580.
SANTOS CC, et al. Prevalência de infecções urinárias e do trato genital em gestantes atendidas em Unidades Básicas de Saúde Rev. Ciênc. Méd. 2018;27(3):101-113.
SILVA LR, et al. Infecção do trato urinário em pacientes idosos em atendimento domiciliar: prevalência, manifestações clínicas e tratamento. Revista Eletrônica Acervo Científico (REAC), 2020;10: e3288.
TULA A, et al. Bacterial Profile and Antibiotic Susceptibility Pattern of Urinary Tract Infection among Pregnant Women Attending Antenatal Care at a Tertiary Care Hospital in Southern Ethiopia. Can J Infect Dis Med Microbiol. 2020; 17: 5321276.
VASCONCELOS-PEREIRA EF, et al. Urinary Tract Infection In High Risk Pregnant Women. Revista de Patologia Tropical. Goiânia. 2013; 42(1): 21-29.
VÁSQUEZ GMB, et al. Infección de tracto urinario en la infancia. Papel de la Escherichia coli. Pol. Con., 2021; 6(2): 521-540.
WINGERT A, et al. Asymptomatic bacteriuria in pregnancy: Systematic reviews of screening and treatment effectiveness and patient preferences. BMJ Open. 2019; 9(3): e021347.