Prevalence of urinary tract infections and antibiotic susceptibility among pregnant women

Original Research

Abstract

Background: Urinary tract infection (UTI) is a health problem that must be taken care of during pregnancy. If not treated promptly, UTIs can progress to severe and leave unpredictable complications for both mother and fetus. Currently, in Vietnam, there are few studies on UTIs in pregnancy, especially on pathogens as well as their antibiotic susceptibility characteristics.

Objectives: This study was conducted to determine the bacteria rates among pregnant women with UTI symptoms and antibiotic resistance patterns.

Methods: In a cross-sectional survey, a total of 178 pregnant women at Thuan Kieu General Clinic from 05/2022 to 07/2022 were recruited. Urine from these patients was cultured on BA, MC, and CHROMagarTM Orientation.

Results: The infection ratio was 30.3%. The rate of Gram-positive cocci was 77.8%, and the rate of Gram-negative bacilli was 22.2%. Specifically, the highest proportion was the group of Staphylococcus coagulase negative with 26 samples at 46.3%; Staphylococcus aureus was isolated in all 8 samples at 14.8%; samples infected with Streptococci and Enterococci at 14.8% and 1.9%; 6 samples infected with E. coli with 11.1%; 4 samples infected by Acinetobacter sp with 7.4%; and the remaining were infected with Klebsiella sp with 3.7%. In addition, in the study, two samples of Staphylococci resistant to Methicillin were isolated at 3.7%. The rate of pathogenic bacteria resistant to the old single antibiotics of the β-lactam is high, while the combined antibiotics give good treatment efficiency with both negative and positive cultures.

Conclusion: The rate of UTI in pregnant women is 30.3%. Pathogens mainly found include Staphylococcus aureus, E. coli, Klebsiella sp, and Acinetobacter sp. E. coli is no longer the leading cause of UTIs. As a replacement, there was an increase in Gram-positive cocci as Staphylococci. Recommended antibiotics for UTIs are nitrofurantoin, and β-lactam antibiotics in combination, such as amoxicillin-clavulanate, and piperacillin-tazobactam.

Graphical abstract

CHROMagarTM Strep B for detecting group B Streptococcus in pregnant women at 35th to 37th of gestation

Original Research

Abstract

Introduction: Group B Streptococcus (GBS) is one of the common causes of neonatal sepsis spreading from mothers to newborns. A common method to isolate and identify GBS is using Blood agar which delivers results in at least 48 hours. Although chromogenic culture media including CHROMagarTM StrepB, can develop colored colonies for detecting pathogenic bacteria easily, there has not been approached GBS isolation in Vietnam. This study was conducted to find out the GBS infection ratio in pregnant women at the 35th – 37th week of gestation. Furthermore, this research evaluates the efficacy of CHROMagarTM StrepB media and Blood agar in GBS detection as well.

Method: In a cross-sectional survey, a total of 258 pregnant women at 35th to 37th of gestation screened for GBS at Thuan Kieu General Clinic from 04/2021 to 12/2021 were recruited. Rectovaginal swabs from these patients were cultured on Blood agar and CHROMagarTM StrepB. We performed data analysis using SPSS ver 20, p<0.05 was statistically significant.

Result: Overall, out of 258 participants, 52 (20.16%) were GBS carriers. CHROMagarTM StrepB has significantly higher sensitivity than blood agar if spending a similar time (1.52 fold, p-value < 0.001), or event training a shortened time (18 hours and 48 hours), CHROMagarTM StrepB media is still more sensitive than blood agar (1.16 fold, p-value 0.044).

Conclusion: In this study, the GBS infection ratio in pregnant women at 35-37 weeks of gestation at Thuan Kieu General Clinic is 20.16%. Culturing vaginal-rectal specimens on CHROMagarTM StrepB medium is higher sensitivity and rapidly than blood agar for GBS detection. CHROMagarTM StrepB should be used to get more effective in identifying GBS carriers in near-term pregnant women. 

Graphical abstract

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