gynecology and obstetrics medical project, gynecology journal, obstetrics, gynecologic oncology, reproductive medicine, gynecological endoscopy, ultrasonography, gynecology articles

Ginekologia i Poloznictwo
ISSN 1896-3315 e-ISSN 1898-0759

Urinary tract infections in pregnant women and antimicrobial resistance of responsible pathogens in Ukraine: results of a multicenter study (2016-2018)


Author(s): Aidyn Gurbanovych Salmanov, Olga Gorbunova, Olha Leshchova, Dmitriy Govseev, Dmytro Zhelezov, Alla Vitiuk, Stella Kushnirenko

Introduction. Urinary Tract Infections (UTIs) are one of the most common microbial diseases among the pregnant women threat worldwide. However, studies of prevalence of UTIs in the pregnant women in Ukraine are scant. The aim of this study was to obtain the first estimates of the current prevalence of UTIs in the pregnant women and antimicrobial resistance of responsible pathogens in Ukraine. Materials and Methods. We performed a retrospective multicenter cohort study. The study population consisted of 27,388 pregnant women from 9 regions of Ukraine. Microbial isolates were identified using standard microbiological techniques, including automated microbiology testing. Isolates were categorized as susceptible or resistant by Clinical and Laboratory Standards Institute criteria. Results. Total 24.3% pregnant women were found to have UTIs. Among these patients, 57.5% Asymptomatic bacteriuria, 35% Cystitis and 7.6% Pyelonephritis were observed. The predominant pathogens were: Escherichia coli (36.2%), Enterococcus faecalis (19.5%), Klebsiella pneumoniae (11.1%), Enterobacter spp. (7.2%), Pseudomonas aeruginosa (6.4%), and Proteus spp. (4.2%). The overall proportion of methicillin- resistance was observed in 11.2% of Staphylococcus aureus (MRSA). Vancomycin resistance was observed in 3.2% of isolated enterococci. Carbapenem resistance was identified in 6.3% of P.aeruginosa isolates. Resistance to third-generation cephalosporins was observed in 9.7% Klebsiella spp. and E.coli 12.8% isolates. The overall proportion of extended spectrum beta-lactamases (ESBL) production among Enterobacteriaceae was 24.8%. The prevalence of ESBL production among E. coli isolates was significantly higher than in K. pneumoniae (34.1%, vs 11.7%). Conclusions. A UTIs in the pregnant women in Ukraine is a common occurrence and many cases are caused by pathogens that are resistant to antibiotics. Given of the rapidly developing antimicrobial resistance, the policy of antibiotic use for UTIs treatment in each region should be determined depending on local data on resistance to antimicrobials.