Susceptibilidad antimicrobiana de enterobacterias adquiridas en comunidad que causan infecciones urinarias durante el embarazo

Abstract

Background: urinary tract infections (UTIs) during pregnancy are among the most common complications, especially in the first trimester, with an estimated prevalence of 20–30 %. This research aimed to determine the most frequent enterobacteriaceae and their antimicrobial susceptibility profile to antibiotics commonly used at the primary care level for UTI in pregnant women, as well as to evaluate the associated maternal-fetal morbidity.

Methods: an observational, descriptive, retrospective study was conducted, based on urine culture reports of patients who attended the Hospital de la Mujer de Culiacán IMSS-Bienestar with symptoms suggestive of urinary tract infection between August 2, 2021 and July 28, 2022. Pregnant women of any gestational age who underwent urine culture and antibiotic susceptibility testing were included. A qualitative detection of beta-lactamase production was performed according to the microorganism and the antibiotic evaluated. The data were analyzed using version 13.0 of Stata.

Results: a total of 476 records were analyzed. The mean age was 25.40 ± 7.75 years, and the mean gestational age was 30.54 ± 10.60 weeks. A total of 369 cases of infection by Escherichia coli (77.52 %), 27 of Proteus vulgaris (5.67 %) and 80 of Klebsiella pneumoniae (16.80 %) were identified. The susceptibility of Escherichia coli to ampicillin, cephalotin and nitrofurantoin was 45 %, 51 % and 94 %, respectively; for K. pneumoniae, 0 %, 80 % and 50 %; and for P. vulgaris, 70 %, 89 % and 3.7 %. The highest morbidity was observed in cases of UTIs caused by Escherichia coli.

Conclusion: Escherichia coli was the predominant causative agent and exhibited low susceptibility to certain commonly used antibiotics at the primary care level, highlighting the need for local surveillance of antimicrobial resistance and optimization of empirical treatment.