Profile of uropathogens in pregnancy over 5 years from a large tertiary center in South India

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dc.contributor.authorDavid, LSen_US
dc.contributor.authorVarunashree, NDen_US
dc.contributor.authorEbenezer, EDen_US
dc.contributor.authorNavaneethan, PRen_US
dc.contributor.authorTirkey, RSen_US
dc.contributor.authorRathore, Sen_US
dc.contributor.authorMahasampath, Gowrien_US
dc.contributor.authorDavid, Thambuen_US
dc.contributor.authorMathews, Jiji Elizabethen_US
dc.contributor.authorSahni, Rani Dianaen_US
dc.date.accessioned2023-08-09T06:47:44Z
dc.date.available2023-08-09T06:47:44Z
dc.date.issued2022-12
dc.description.abstractObjectives: Urinary tract infections (UTIs) are a common medical problem in both antenatal and postnatal women. Data from India on the demography of these women, microbiology and antimicrobial susceptibility of the causative bacteria, need elucidation. Material and Methods: We performed an observation study that collected data on UTI in antenatal and postnatal women between 2013 and 2017 at our tertiary care center in South India. Antenatally, urine dipstick-positive patients, high-risk, and symptomatic patients submitted urine cultures. Postnatally, all symptomatic patients had urine cultures. This was 20% of all antenatal and postnatal women resulting in 20,203 cultures. Results: Of 20,203 cultures, significant bacteriuria was seen in 9.48% of antenatal and 13.28% of postnatal women. A higher mean age was seen among those with UTI, antenatal 27 (SD 3.5) and postnatal 26.4 (SD 4.7) years versus 23.9 (SD 3.6) with no growth in culture. The mean BMI among antenatal was 28.2 (SD 3.5) and postnatal was 28 (SD 7.4). Most (60%) were primigravida. At delivery, 37% required cesarean sections while 21.2% required instrumental delivery. Recurrent UTI was seen in 25% antenatally and 10% in the postnatal period. Escherichia coli accounted for 66 and 60% of infections among antenatal and postnatal women, respectively. Enterococcus species accounted for 13% in both while Klebsiella species was 4.9 and 7.3%, respectively. Among E. coli, 68.3 and 59.2% of isolates in antenatal and postnatal period were cefpodoxime susceptible. Nearly 75% of ante- and postnatal isolates were susceptible to amoxicillin-clavulanate while 90.2% and 92.5% were susceptible to nitrofurantoin. Enterococci spp. up to 84.4 and 97.1% in ante- and postnatal isolates were susceptible to ampicillin, 64.4 and 77.4% susceptible to high-level gentamicin, and 84 and 95.5% susceptible to nitrofurantoin. Asymptomatic bacteriuria in pregnancy was documented in 2.1% of antenatal outpatients and E. coli was isolated in 74% of these cultures. Conclusion: Importance of microbiological evidence prior to administration of antimicrobials is evidenced by 79% negative cultures in this 5-year cohort. Escherichia coli accounted for 60-66% of significant bacteriuria followed by Enterococcus and Klebsiella species with 30-40% E.coli probable ESBL producers. Nitrofurantoin followed by amoxicillin-clavulanate were found to be the best oral antimicrobial options.en_US
dc.identifier.affiliationsDepartments of Obstetrics and Gynecology,en_US
dc.identifier.affiliationsBio-Statisticsen_US
dc.identifier.affiliationsMedicine,en_US
dc.identifier.affiliationsMicrobiology, Christian Medical College, Vellore, Tamil Nadu, Indiaen_US
dc.identifier.citationDavid LS, Varunashree ND, Ebenezer ED, Navaneethan PR, Tirkey RS, Rathore S, Mahasampath Gowri, David Thambu, Mathews Jiji Elizabeth, Sahni Rani Diana. Profile of uropathogens in pregnancy over 5 years from a large tertiary center in South India. Indian Journal of Medical Sciences. 2022 Dec; 74(3): 112-117en_US
dc.identifier.issn1998-3654
dc.identifier.issn0019-5359
dc.identifier.placeIndiaen_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/222854
dc.languageenen_US
dc.publisherScientific Scholaren_US
dc.relation.issuenumber3en_US
dc.relation.volume74en_US
dc.source.urihttps://doi.org/10.25259/IJMS_525_2021en_US
dc.subjectUrinary tract infectionsen_US
dc.subjectAsymptomatic bacteriuriaen_US
dc.subjectPregnancyen_US
dc.subjectUropathogensen_US
dc.titleProfile of uropathogens in pregnancy over 5 years from a large tertiary center in South Indiaen_US
dc.typeJournal Articleen_US
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