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. 2020 Apr 21:2020:9681632.
doi: 10.1155/2020/9681632. eCollection 2020.

Urinary Tract Infections among Indonesian Pregnant Women and Its Susceptibility Pattern

Yeva Rosana  1 , Dwiana Ocviyanti  2 , Melissa Halim  3 , Friza Yossy Harlinda  3 , Rahmah Amran  3 , Wafridha Akbar  3 , Matthew Billy  3 , Syadza Rhizky Putri Akhmad  3
Affiliations

Urinary Tract Infections among Indonesian Pregnant Women and Its Susceptibility Pattern

Yeva Rosana et al. Infect Dis Obstet Gynecol. .

Abstract

Pregnant women are usually at risk of urinary tract infections (UTIs) such as asymptomatic bacteriuria. In the current multidrug-resistance era, appropriate diagnosis and treatment should be provided to avoid complications in pregnant women in developing countries, which have limited facilities, such as Indonesia. The aim of this study was to evaluate in vitro susceptibility tests. Urinary isolates were collected from 715 pregnant women who visited eight Community Health Centers in Jakarta, Indonesia, between 2015 and 2017. We identified bacterial uropathogens from samples that were positive for nitrite/leukocyte esterase (LE), using two types of VITEK cards. Since noncompliance among patients is a major problem, fosfomycin-trometamol 3 g single-dose sachets were given to the patients, and the side effects of the medication and neonatal outcomes were reported. Asymptomatic bacteriuria was found in 10.5% of the 715 pregnant women. Escherichia coli was the most common etiological factor (26.7%), followed by Klebsiella pneumoniae (20%), Streptococcus agalactiae (9.3%), Enterobacter cloacae (5.3%), Enterococcus faecalis (5.3%), Staphylococcus saprophyticus (4%), Acinetobacter baumannii (4%), and others. Out of 76 pregnant women who took fosfomycin-trometamol, two complained of diarrhea that subsided without medication and fever that responded to paracetamol. Neonatal outcomes showed 100% full-term and normal-weight babies. E. coli, including extended-spectrum beta-lactamase- (ESBL-) producing E. coli, was 100% susceptible to fosfomycin. Nitrite/LE test results are often used as evidence for empiric antibiotic administration for treating asymptomatic bacteriuria in pregnancy, but the diagnosis should be confirmed using culture tests. Based on in vitro susceptibility patterns and medication outcomes, fosfomycin-trometamol single dose could be administered to noncompliant UTI patients, including pregnant women.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Figure 1
Figure 1
The pattern of bacteria found in pregnant women with asymptomatic bacteriuria in Jakarta, Indonesia.
Figure 2
Figure 2
Percentage of E. coli isolates susceptible to antimicrobial drug. TMP/SMX: trimethoprim/sulfamethoxazole; Ampi-Sulb: ampicillin-sulbactam; Pip/Tazo: piperacillin-tazobactam.
Figure 3
Figure 3
Percentage of Klebsiella pneumoniae isolates susceptible to antimicrobial drug. TMP/SMX: trimethoprim/sulfamethoxazole; Ampi-Sulb: ampicillin-sulbactam; Pip/Tazo: piperacillin-tazobactam.
Figure 4
Figure 4
Percentage of Gram-positive bacteria isolates susceptible to antimicrobial drug. TMP/SMX: trimethoprim/sulfamethoxazole.
Figure 5
Figure 5
Susceptibility pattern of E.coli, K. pneumoniae, S. agalactiae, E. faecalis to antimicrobial drugs. Ampi-sulbactam: ampicillin-sulbactam; TMP/SMX: trimethoprim/sulfamethoxazole.
See this image and copyright information in PMC

References

    1. Garnizov T. M. Asymptomatic bacteriuria in pregnancy from the perspective of public health and maternal health care: review and case report. Biotechnology & Biotechnological Equipment. 2016;30(3):443–447. doi: 10.1080/13102818.2015.1114429. - DOI
    1. Santoso B. I., Surya R., Yasmin F. A., Irwinda R. The awareness of urinary tract infection management in pregnant women. A qualitative study. Majalah Obstetri & Ginekologi. 2018;25(3):92–96. doi: 10.20473/mog.v25i32017.92-96. - DOI
    1. Jido T. A. Urinary tract infections in pregnancy: evaluation of diagnostic framework. Saudi Journal of Kidney Diseases and Transplantation. 2014;25(1):85–90. doi: 10.4103/1319-2442.124496. - DOI - PubMed
    1. Matuszkiewicz-Rowińska J., Małyszko J., Wieliczko M. Urinary tract infections in pregnancy: old and new unresolved diagnostic and therapeutic problems. Archives of Medical Science. 2015;11(1):67–77. doi: 10.5114/aoms.2013.39202. - DOI - PMC - PubMed
    1. Jain V., Das V., Agarwal A., Pandey A. Asymptomatic bacteriuria & obstetric outcome following treatment in early versus late pregnancy in north Indian women. The Indian Journal of Medical Research. 2013;137(4):753–758. - PMC - PubMed

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