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
. 2023 Nov 28:21:100263.
doi: 10.1016/j.eurox.2023.100263. eCollection 2024 Mar.

Bacterial abundance and antimicrobial resistance patterns of uropathogens among pregnant women with asymptomatic bacteriuria: Association with glycemic status

Dalia Rafat  1 , Anubha Agrawal  1 , Shamsi Khalid  2 , Asad U Khan  2 , Tabassum Nawab  3 , Asfia Sultan  4
Affiliations

Bacterial abundance and antimicrobial resistance patterns of uropathogens among pregnant women with asymptomatic bacteriuria: Association with glycemic status

Dalia Rafat et al. Eur J Obstet Gynecol Reprod Biol X. .

Abstract

Objectives: Antimicrobial resistance (AMR), a growing global menace, poses a significant threat to maternal and fetal health. Gestational diabetes mellitus (GDM) causes double trouble in pregnancy, increasing the risk of a variety of infectious morbidities while also raising the possible association with AMR. Asymptomatic bacteriuria (ASB) is a common problem in pregnancy, but little research has been done to date explicitly examining the relationship between GDM and ASB and yielded conflicting results. Even fewer studies have specifically examined the relationship between GDM and AMR in women with ASB. Retrieving the most recent information on the disease burden, the range of causative pathogens, their patterns of AMR, and associated risk factors in pregnant women is crucial to stop the exponential rise in AMR in pregnancy and improve maternal and neonatal outcomes of infectious morbidities. Hence, this study was planned to investigate the association between glycemic status and the contemporary bacterial profile, antimicrobial resistance(AMR), and associated variables among pregnant women with ASB.

Study design: This prospective, hospital-based, cross-sectional study was conducted among 320 pregnant women; divided into two groups, GDM and non-GDM. Data regarding sociodemographic and clinical characteristics were collected using a structured questionnaire. Clean-catch midstream urine samples were investigated for the presence of significant bacterial uropathogens and their AMR pattern was determined using recommended culture methods.

Results: We found ASB in 46.25% of study participants with significantly higher occurrence in the GDM group. Dominant isolates were Escherichia coli followed by Klebsiella pneumoniae. AMR was noted in 51.35% and multidrug resistance(MDR) in 23.65% of isolates. Overall AMR, MDR and higher degrees of AMR were higher among uropathogens isolated from the GDM group as compared to the non GDM group, although the difference was not statistically significant.

Conclusion: The high occurrence of ASB in pregnancy along with substantially high AMR in this study suggests the need for effective infection control and stewardship programmes. By defining the association of ASB and AMR with hyperglycemia, our study calls for the exploitation of this potential association in halting the pandemic of AMR and in improving the management of infectious morbidities, thus in-turn alleviating their undesired maternal and infant outcomes.

Keywords: Antimicrobial resistance; Asymptomatic Bacteriuria; Gestational diabetes mellitus; Multidrug resistance; Pregnancy.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
: Distribution of bacterial pathogens isolated from urine culture of asymptomatic pregnant women with and without Gestational Diabetes Mellitus.
Fig. 2
Fig. 2
: Association of mean fasting, 1-hour and 2-hour blood glucose levels with (a) asymptomatic bacteriuria and (b) antimicrobial resistance.
Fig. 3
Fig. 3
: Comparison of resistance to antimicrobials in asymptomatic bacteriuria among pregnant women with and without Gestational Diabetes Mellitus.
Fig. 4
Fig. 4
: ROC Curve for the factors associated with asymptomatic bacteriuria.
Fig. 5
Fig. 5
: ROC Curve for the factors associated with antimicrobial resistance.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Addo V.N. In: Comprehensive Obstetrics in the Tropics. Dansoman. Kwawukume E.Y., Emuveyan E.E., editors. Asante and Hittscher Printing Press Limited; 2002. Urinary Tract Infection in pregnancy; pp. 261–267.
    1. Nicolle L.E. Asymptomatic bacteriuria: when to screen and when to treat. Infect Dis Clin North Am. 2003;17:367–394. - PubMed
    1. Akerele P., Abhuliren F., Okonofua J. Prevalence of asymptomatic bacteriuria among pregnant women in Benin City. Nigeria. J Obstruct Gynaecol. 2001;21:141–144. - PubMed
    1. Rafat D., Singh S., Nawab T., Khan F., Khan A.U., Khalid S. Association of vaginal dysbiosis and gestational diabetes mellitus with adverse perinatal outcomes. Int J Gynaecol Obstet. 2022;158(1):70–78. - PubMed
    1. Paudel S., John P.P., Poorbaghi S.L., Randis T.M., Kulkarni R. Systematic review of literature examining bacterial urinary tract infections in diabetes. J Diabetes Res. 2022;2022 - PMC - PubMed

LinkOut - more resources