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Prevalence of asymptomatic bacteriuria among pregnant women and changes in antibiotic resistance: a 6-year retrospective study

Prevalence of asymptomatic bacteriuria among pregnant women and changes in antibiotic resistance: a 6-year retrospective study
Prevalence of asymptomatic bacteriuria among pregnant women and changes in antibiotic resistance: a 6-year retrospective study

Objective: asymptomatic bacteriuria (ASB) during pregnancy is a risk factor for development of urinary tract infections and pyelonephritis, which can lead to maternal and foetal consequences. This study aimed to determine the prevalence of ASB during pregnancy, the most common causative pathogens and their resistance patterns. 

Methods: a retrospective analysis was performed using microbiology laboratory data from urine sample cultures from pregnant women collected at our University hospital over a 6-year period (2014–2019). Identification and susceptibility testing were performed using standard microbiology procedures based on British Society of Antimicrobial Chemotherapy and European Committee on Antimicrobial Susceptibility Testing. 

Results: from a total of 18,938 urine samples, 1522 (8.04%) were positive for bacteriuria, the most common isolates were Escherichia coli and Coliform (lactose fermenters) (n = 1171, 76.9%), followed by Enterococcus faecalis and other enterococci (n = 191, 12.5%). In 2019, the resistance of E. coli was 56.8%, 25.3% and 4.7% to amoxicillin, trimethoprim and gentamicin, respectively, with an increasing pattern of resistance to trimethoprim and gentamicin from 2014 to 2019. The resistance rates to nitrofurantoin were 1% and 5.5% for E. coli and Group B Streptococcus, respectively. 

Conclusion: our study shows the trends of antimicrobial resistance in this vulnerable group and will help confirm treatment effectiveness and direct guideline recommendations locally and internationally. Level of Evidence: 2b

Asymptomatic bacteriuria, antibiotic stewardship, antimicrobial resistance, susceptibility testing, urinary tract infections
2051-4158
Cotton, Erin
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Geraghty, Robert
ae93ecce-01a6-42d2-8d06-b961db0aaaad
Umranikar, Sameer
f18ed32c-179a-4620-b8dc-20eeac28b93b
Saeed, Kordo
87cb67e5-71e8-4759-bf23-2ea00ebd8b39
Somani, Bhaskar
7ed77b4e-3ffc-43ef-bc61-bd1c1544518c
Cotton, Erin
772f21de-f6f1-4636-8b6d-f50ff4a55e63
Geraghty, Robert
ae93ecce-01a6-42d2-8d06-b961db0aaaad
Umranikar, Sameer
f18ed32c-179a-4620-b8dc-20eeac28b93b
Saeed, Kordo
87cb67e5-71e8-4759-bf23-2ea00ebd8b39
Somani, Bhaskar
7ed77b4e-3ffc-43ef-bc61-bd1c1544518c

Cotton, Erin, Geraghty, Robert, Umranikar, Sameer, Saeed, Kordo and Somani, Bhaskar (2022) Prevalence of asymptomatic bacteriuria among pregnant women and changes in antibiotic resistance: a 6-year retrospective study. Journal of Clinical Urology. (doi:10.1177/20514158221095672).

Record type: Article

Abstract

Objective: asymptomatic bacteriuria (ASB) during pregnancy is a risk factor for development of urinary tract infections and pyelonephritis, which can lead to maternal and foetal consequences. This study aimed to determine the prevalence of ASB during pregnancy, the most common causative pathogens and their resistance patterns. 

Methods: a retrospective analysis was performed using microbiology laboratory data from urine sample cultures from pregnant women collected at our University hospital over a 6-year period (2014–2019). Identification and susceptibility testing were performed using standard microbiology procedures based on British Society of Antimicrobial Chemotherapy and European Committee on Antimicrobial Susceptibility Testing. 

Results: from a total of 18,938 urine samples, 1522 (8.04%) were positive for bacteriuria, the most common isolates were Escherichia coli and Coliform (lactose fermenters) (n = 1171, 76.9%), followed by Enterococcus faecalis and other enterococci (n = 191, 12.5%). In 2019, the resistance of E. coli was 56.8%, 25.3% and 4.7% to amoxicillin, trimethoprim and gentamicin, respectively, with an increasing pattern of resistance to trimethoprim and gentamicin from 2014 to 2019. The resistance rates to nitrofurantoin were 1% and 5.5% for E. coli and Group B Streptococcus, respectively. 

Conclusion: our study shows the trends of antimicrobial resistance in this vulnerable group and will help confirm treatment effectiveness and direct guideline recommendations locally and internationally. Level of Evidence: 2b

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More information

Accepted/In Press date: 27 March 2022
e-pub ahead of print date: 16 May 2022
Additional Information: Publisher Copyright: © British Association of Urological Surgeons 2022.
Keywords: Asymptomatic bacteriuria, antibiotic stewardship, antimicrobial resistance, susceptibility testing, urinary tract infections

Identifiers

Local EPrints ID: 468520
URI: http://eprints.soton.ac.uk/id/eprint/468520
ISSN: 2051-4158
PURE UUID: 5cd95184-d833-4101-b5d7-6b8311403956
ORCID for Kordo Saeed: ORCID iD orcid.org/0000-0003-0123-0302

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Date deposited: 17 Aug 2022 16:31
Last modified: 18 Aug 2022 01:56

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Contributors

Author: Erin Cotton
Author: Robert Geraghty
Author: Sameer Umranikar
Author: Kordo Saeed ORCID iD
Author: Bhaskar Somani

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