Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Apr;146(6):771-774.
doi: 10.1017/S0950268818000365. Epub 2018 Mar 14.

Outcomes of UTI and bacteriuria caused by ESBL vs. non-ESBL Enterobacteriaceae isolates in pregnancy: a matched case-control study

Y Yagel  1 , H Nativ  1 , K Riesenberg  1 , L Nesher  1 , L Saidel-Odes  1 , R Smolyakov  1
Affiliations

Outcomes of UTI and bacteriuria caused by ESBL vs. non-ESBL Enterobacteriaceae isolates in pregnancy: a matched case-control study

Y Yagel et al. Epidemiol Infect. 2018 Apr.

Abstract

Infections caused by extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-E) have become increasingly prevalent, posing a serious public threat worldwide. It is commonly believed that untreated urinary tract infections (UTI) and asymptomatic bacteriuria (ABU) during pregnancy are associated with poor obstetric outcomes. Currently, there is a paucity of data regarding the outcomes or risk factors of such ESBL-E infections in pregnant women. We conducted a retrospective 1:2 matched case-control study of hospitalised pregnant women with ESBL-E- vs. non-ESBL-producing Enterobacteriaceae-positive urine cultures obtained between 2004 and 2015, and compared risk factors for the development of resistant bacteria, clinical course and outcomes. In total, 87 pregnant women with ESBL-E-positive urine cultures were matched to 174 controls by decade of age, ethnicity and pregnancy trimester. Significant risk factors for acquisition of ESBL-E included prior UTI/ABU episodes (50.6% vs. 26.3%, P < 0.001), previous isolation of ESBL-E in urine cultures (12.6% vs. 0.6%, P < 0.001) and prior antibiotic exposure (71.3% vs. 54%, P = 0.002). Previous hospitalisation, however, was not found to be a risk factor. No significant difference was found in adverse obstetric outcomes. We conclude that prior urinary infections and antibiotic exposure were significant risk factors for the isolation of ESBL-E pathogens from the urine of pregnant women; however, this was not associated with worse obstetric outcomes compared with non-ESBL-E pathogens.

Keywords: Asymptomatic bacteriuria; extended-spectrum β-lactamase (ESBL); low birth weight; pregnancy; preterm labour; urinary tract infection.

PubMed Disclaimer

Conflict of interest statement

None.

Figures

Fig. 1.
Fig. 1.
Selection of study population. *Controls were selected using frequency matching according to the year of the positive urine cultures, the women's age decade, ethically (Bedouin Arab vs. non-Bedouin Arab) and pregnancy trimester.
See this image and copyright information in PMC

References

    1. Dielubanza EJ and Schaeffer AJ (2011) Urinary tract infections in women. Medical Clinics of North America 95, 27–41. - PubMed
    1. Smaill FM and Vazquez JC (2015) Antibiotics for asymptomatic bacteriuria in pregnancy. Cochrane Database of Systematic Reviews 8, CD000490. doi: 10.1002/14651858.CD000490.pub3. - DOI - PubMed
    1. Nicolle LE, et al. (2005) Infectious Diseases Society of America guidelines for the diagnosis and treatment of asymptomatic bacteriuria in adults. Clinical Infectious Diseases 5, 643–654. - PubMed
    1. Kazemier BM, et al. (2015) Maternal and neonatal consequences of treated and untreated asymptomatic bacteriuria in pregnancy: a prospective cohort study with an embedded randomized controlled trial. Lancet Infectious Diseases 11: 1324–1333. - PubMed
    1. Karanika S, et al. (2016) Fecal colonization with extended-spectrum beta-lactamase-producing Enterobacteriaceae and risk factors among healthy individuals: a systematic review and meta-analysis. Clinical Infectious Diseases 3, 310–318. - PubMed

MeSH terms