Antibiotic resistance patterns in enterobacteria isolated from urinary tract infections in pregnant women

Authors

DOI:

https://doi.org/10.33448/rsd-v9i8.6337

Keywords:

UTI; Pregnancy; Escherichia coli; Bacteriuria.

Abstract

UTIs are infections usually caused by Gram-negative bacteria, mainly enterobacteria, commonly acquired in the community or in hospitals. The anatomical and physiological changes imposed into the urinary tract by pregnancy may predispose to the transformation of asymptomatic bacteriuric women on pregnant women with symptomatic UTIs, thus investigating the epidemiology of UTI (bacterial isolates and sensitivity to antibiotics) during pregnancy is key to guiding interventions. In the present study,  it was aimed to investigate the presence of enterobacteria that cause bacteriuria and UTI in pregnant women in the city of São João do Triunfo-PR from 2015 to 2019. From  176 samples, we detected the presence of Escherichia coli in 95 (54%), of the clinical samples, Klebsiella sp. in 35 (19,9%), followed by Proteus sp. 29 (16,5%) and Enterobacter sp 17(9,6%). Concerning antimicrobial resistance, the highest rates of multiresistance were observed among Escherichia coli isolates, where 20%  isolates were resistant to four or more antibiotics and 3,1%  isolates were resistant to more than six antimicrobial agents.  Klebsiella sp. were the most sensitive to the antimicrobials tested, 68,6% were sensitive to all the antibiotics studied. Infections caused by Escherichia coli were commonly related to high counts of colony-forming units (CFU), in which case 84,2% of samples were counted above 100,000 CFU/mL, while all samples positive for Klebsiella sp., Enterobacter sp. and Proteus sp.  produced infections with counts below 100,000 CFU/mL. Our results demonstrate that Escherichia coli is the main enterobacterium that causes UTI in pregnant women, mainly through multi-drug resistance strains, whereas Klebsiella sp., Enterobacter sp. and Proteus sp. produced only bacteriuria.

References

Ballesteros-Monrreal, M. G., Arenas-Hernández, M. M., Enciso-Martínez, Y., Martínez-de la Peña, C. F., del C Rocha-Gracia, R., Lozano-Zaraín, P., Navarro-Ocaña, A., Martínez-Laguna, Y., & de la Rosa-López, R. (2020). Virulence and Resistance Determinants of Uropathogenic Escherichia coli Strains Isolated from Pregnant and Non-Pregnant Women from Two States in Mexico. Infection and Drug Resistance, 13, 295.

Brasil. Ministério da Saúde (BR). Agência Nacional de Vigilância Sanitária - ANVISA. (2013). Manual de Microbiologia Clínica para o Controle de Infecção Relacionada à Assistência a Saúde. Módulo 3: Principais Síndromes Infecciosas. Brasília.

Carvalho, F. A., Rodrigues, M. D. A., Bottega, A., & Hörner, R. (2016). Prevalência e perfil de sensibilidade de bactérias isoladas da urina de gestantes atendidas no serviço de obstetrícia de um hospital terciário. Scientia Medica, 26(4).

Cortes-Penfield, N. W., Trautner, B. W., & Jump, R. L. (2017). Urinary tract infection and asymptomatic bacteriuria in older adults. Infectious Disease Clinics, 31(4), 673-688.

Costa, M., Pereira, P. M., Bolotinha, C., Ferreira, A., Cardoso, R., Monteiro, C., Gomes, C. F., & Gomes, J. F. (2009). Frequência e Susceptibilidade Bacteriana em Infecções Urinárias –dados de um laboratório de Lisboa. Parte II. Revista Lusófona de Ciências e Tecnologias da Saúde, 6, 87–103.

De Queiroz, G. M., da Silva, L. M., Pietro, R. C. L. R., & Salgado, H. R. N. (2012). Multirresistência microbiana e opções terapêuticas disponíveis. Revista da Sociedade Brasileira de Clínica Medica, 10(2), 132-8.

Dougnon, V., Assogba, P., Anago, E., Déguénon, E., Dapuliga, C., Agbankpè, J., Zin, S., Akotegnon, R., Moussa, L. B. & Bankolé, H. (2020). Enterobacteria responsible for urinary infections: a review about pathogenicity, virulence factors and epidemiology. Journal of Applied Biology & Biotechnology, 8(01), 117-124.

Falagas, M. E. & Karageorgopoulos, D. E. (2009). Extended-spectrum β-lactamase producing organisms. Journal of Hospital Infection, 73(4):345-54.

Figueiredo, A., Gomes, G. & Campos, A. (2012). Urinary tract infections in pregnancy – diagnosis treatment and prevention. Acta Obstetrica e Ginecológica Portuguesa, 6(3):124-33.

Foxman B. (2010). The epidemiology of urinary tract infection. Nature Reviews Urology, 7:653–660.

Foxman B. (2014). Urinary tract infection syndromes: occurrence, recurrence, bacteriology, risk factors, and disease burden. Infectious Diseases Clinics of North America, 28:1–13.

Harbottle, H., Thakur, S., Zhao, S., & White, D. G. (2006). Genetics of antimicrobial resistance. Animal Biotechnology, 17:111-124.

Koch, C. R., Ribeiro, J. C., Schnor, O. H., Zimmermann, B. S., Müller, F. M., D'Agostin, J., Machado, V. & Zhang, L. (2008). Antimicrobial resistance of uropathogens among outpatients, 2000-2004. Revista da Sociedade Brasileira de Medicina Tropical, 41(3), 277-281.

Kostakioti, M., Hultgren, S. J. & Hadjifrangiskou, M. (2012). Molecular blueprint of uropathogenic Escherichia coli virulence provides clues toward the development of anti-virulence therapeutics. Virulence, 3:592–594.

Mahmudunnabi, G., Momtaz, F., Foysal, M. J., Rahman, M. M., & Islam, K. (2018). Molecular detection and PCR-RFLP analysis using Pst1 and Alu1 of multidrug resistant Klebsiella pneumoniae causing urinary tract infection in women in the eastern part of Bangladesh. Journal of Genetic Engineering and Biotechnology, 16(1), 77-82.

Masinde, A., Gumodoka, B., Kilonzo, A., Mshana, S. E. (2009). Prevalence of urinary tract infection among pregnant women at Bugando Medical Centre, Mwanza, Tanzania. Tanzania Journal of Health Research, 11(3),154-9.

Moraes, D., Braoios, A., Alves, J. L. B., & Costa, R. M. D. (2014). Prevalence of uropathogens and antimicrobial susceptibility profile in outpatient from Jataí-GO. Jornal Brasileiro de Patologia e Medicina Laboratorial, 50(3), 200-204.

Naboka, Y. L., Mavzyiutov, A. R., Kogan, M. I., Gudima, I. A., Ivanov, S. N., & Naber, K. G. (2020). Does Escherichia coli have pathogenic potential at low level bacteriuria in recurrent, uncomplicated urinary tract infections?, International Journal of Antimicrobial Agents, Apr:105983.

Omidifar, N., Taghi, E., Mohebi, S., & Motamedifar, M. (2020). Distribution and antimicrobial susceptibility pattern of bacterial pathogens causing urinary tract infection in pregnant women in Shiraz, Southwest Iran. Gene Reports, p.100731.

Rahman, F., Chowdhury, S., Rahman, M. M., Ahmed, D. & Hossain, A. (2009). Antimicrobial resistance pattern of gram-negative bacteria causing urinary tract infection. Stamford Journal of Pharmaceutical Sciences, 2, 44–55.

Schnarr, J., & Smaill, F. (2008). Asymptomatic bacteriuria and symptomatic urinary tract infections in pregnancy. European journal of clinical investigation, 38, 50-57.

Shrestha, R., Khanal, S., Poudel, P., Khadayat, K., Ghaju, S., Bhandari, A., Lekhak, S., Pant, N. D., Sharma, M. & Marasini, B. P. (2019). Extended spectrum β-lactamase producing uropathogenic Escherichia coli and the correlation of biofilm with antibiotics resistance in Nepal. Annals of Clinical Microbiology and Antimicrobials, 18(1), 42.

Wang, T., Wu, G., Wang, J., Cui, Y., Ma, J., Zhu, Z., Qiu, J. & Wu, J. (2020). Comparison of Single-dose Fosfomycin Tromethamine and Other Antibiotics for Lower Uncomplicated Urinary Tract Infection in Women and Asymptomatic Bacteriuria in Pregnant Women: a systematic review and meta-analysis. International Journal of Antimicrobial Agents, p.106018.

Youssef, M. M., Rizk, H. A., & Hassuna, N. A. (2019). Phenotypic and Genotypic Characterization of Extended-Spectrum β-Lactamase-Producing Enterobacteriaceae in Asymptomatic Bacteriuria in Pregnancy. Microbial drug resistance (Larchmont, N.Y.), 25(5), 731–738.

Published

01/08/2020

How to Cite

STELLA, A. E.; OLIVEIRA, A. F. de. Antibiotic resistance patterns in enterobacteria isolated from urinary tract infections in pregnant women. Research, Society and Development, [S. l.], v. 9, n. 8, p. e862986337, 2020. DOI: 10.33448/rsd-v9i8.6337. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/6337. Acesso em: 26 nov. 2024.

Issue

Section

Health Sciences