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Evaluation of Urine and Rectovaginal Culture Results in Pregnant Women with Threatened Preterm Labor

Year 2020, , 66 - 71, 12.12.2020
https://doi.org/10.46332/aemj.715833

Abstract

Purpose: The onset of labor between 20 0/7 and 36 6/7 weeks of pregnancy is described as threatened preterm labor. One of the most important causes are urogenital infections. In this study, we aimed to investigate the relationship between urogenital infections on threatened preterm labor.


Materials and Methods: A total of 45 pregnant patients who were hospitalized in the Gynecology and Obstetrics Clinic between October 2018 and October 2019 with a diagnosis of threatened preterm labor were included in the study. The gynecological examination was performed for each patient, and urine and rectovaginal swab samples were taken for microbiological examination. The obtained data were collected in a database and analyzed.


Results: Reproduction occurred in 24.5% of patients in vaginal culture (n=12), 16.3% in urine culture (n = 8), and 6.1% in rectal culture (n=3). Vaginal culture results were as follows; 5 vaginal candidiasis (Candida albicans), 3 group B streptococcus, 2 Bacterial vaginosis (Gardnerelle vaginalis), 2 Tricomanas vaginalis. Urine culture results were as follows; 5 Escherichia coli, 2 Staphylococcus aureus, 1 Proteus mirabilis. Rectal culture results: 3 rectovaginal group B streptococcus. Preterm labor was observed in only one of culture positive patients who were treated with appropriate antibiotherapy.


Conclusions: Urinary and rectovaginal culture and appropriate treatment according to the identified pathogen are the most important steps to be taken to prevent the progression of labor.

References

  • 1. Beck S, Wojdyla D, Say L, et al. The worldwide incidence of preterm birth: a systematic review of maternal mortality and morbidity. Bull World Health Organ. 2010;88:31-38
  • 2. Suman V, Luther EE. Preterm labor. Stat Pearls. StatPearls Publishing; 2019.
  • 3. Armson AB. Preterm labor. Vincenzo Berghella, editors. Obstetric Evidence-Based Guidelines. 3. Ed., Philadelphia, CRC Press; 2017:213-227
  • 4. Sameshima H, Saito S, Matsuda Y, et al. Annual report of the Perinatology Committee, Japan Society of Obstetrics and Gynecology, 2016: Overall report on a comprehensive retrospective study of obstetric management of preterm labor and preterm premature rupture of the membranes. J Obstet Gynaecol Res. 2018;4(1):5-12.
  • 5. American College of Obstetricians and Gynecologists. Practice Bulletin No. 171: Management of Preterm Labor. Obstet Gynecol. 2016;128(4):155-164
  • 6. Lockwood CJ. Predicting premature delivery- no easy task. N Eng J Med. 2002;346(4):282–284.
  • 7. Balkaya NA, Vural G, Eroğlu K. Gebelikte belirlenen risk faktörlerinin anne ve bebek sağlığı açısından ortaya çıkardığı sorunlar. Düzce Tıp Fak Derg. 2014;1(1):6-16.
  • 8. Giraldo PC, Araújo ED, Junior JE, Amaral RLGD, Passos MR, Gonçalves AK. The prevalence of urogenital infections in pregnant women experiencing preterm and full-term labor. Infect Dis Obstet Gynecol. 2012. Article ID: 878241
  • 9. Bianchi-Jassir F, Seale AC, Kohli-Lynch M, et al. Preterm birth associated with group B Streptococcus maternal colonization worldwide: systematic review and meta-analyses. Clin Infect Dis. 2017;65(2):133-142.
  • 10. Koutarou D. Multiple Mechanisms of Preterm Labor Other Than Intrauterine Infection. Hiroshi Sameshima, editor. Preterm Labor and Delivery. Singapore:Springer;2020:89-94 11. Klinik örnekten sonuç raporuna uygulama rehberi, Genital Sistem Örnekleri KLİMUD, Çağhan Ofset Matbaacılık Ltd. Şti. 2015, Erişim linki: https://www.klimud.org/public/ uploads/files/genital-sistem-ornekleri.pdf. Erişim tarihi: 7 Nisan, 2020.
  • 12. Machado A, Castro J, Cereija T, Almeida C, Cerca N. Diagnosis of bacterial vaginosis by a new multiplex peptide nucleic acid fluorescence in situ hybridization method. Peer J. 2015;3:e780.
  • 13. Machado D, Castro J, Martinez-de-Oliveira J, Nogueira-Silva C, Cerca, N. Prevalence of bacterial vaginosis in Portuguese pregnant women and vaginal colonization by Gardnerella vaginalis. Peer J. 2017;5:e3750.
  • 14. Sabour S, Arzanlou M, Vaez H, Rahimi G, Sahebkar A, Khademi F. Prevalence of bacterial vaginosis in pregnant and non-pregnant Iranian women: a systematic review and meta-analysis. Arch Gynecol Obstet. 2018;297(5):1101-1113.
  • 15. Martin DH, Zozaya M, Lillis RA, Myers L, Nsuami MJ, Ferris MJ. Unique Vaginal Microbiota That Includes an Unknown Mycoplasma-Like Organism Is Associated with Trichomonas vaginalis Infection. J Infect Dis. 2013;207(12):1922–1931.
  • 16. Rowley J, Vander Hoorn S, Korenromp E, et al. Chlamydia, gonorrhoea, trichomoniasis and syphilis: global prevalence and incidence estimates, 2016. Bull World Health Organ. 2019;97(8):548-562.
  • 17. Kwatra G, Cunnington MC, Merrall E., et al. Prevalence of maternal colonisation with group B streptococcus: a systematic review and meta-analysis. Lancet Infect Dis. 2016;16(9):1076-1084.
  • 18. Alp F, Findik D, Dagi HT, Arslan U, Pekin AT, Yilmaz SA. Screening and genotyping of group B streptococcus in pregnant and non-pregnant women in Turkey. J Infect Dev Ctries. 2016;10(3):222-226.
  • 19. Gonçalves B, Ferreira C, Alves CT, Henriques M, Azeredo J, Silva S. Vulvovaginal candidiasis: Epidemiology, microbiology and risk factors. Crit Rev Microbiol. 2016;42(6):905-927.
  • 20. Sutaria P, Cholera M, Donga SB. A prevalence study of vaginal candidiasis among pregnant women. Int J Adv Med. 2019;6(3):922-926.
  • 21. Rogozinska E, Formina S, Zamora J, et al. Accuracy of onsite tests to detect asymptomatic bacteriuria in pregnancy: a systematic review and meta-analysis. Obstet Gynecol. 2016;128(3):495-503.
  • 22. Kalinderi K, Delkos D, Kalinderis M, Athanasiadis A, Kalogiannidis I. Urinary tract infection during pregnancy: current concepts on a common multifaceted problem. J Obstet Gynaecol. 2018;38(4):448-453.
  • 23. Fiona M Smaill, Juan C Vazquez. Antibiotics for asymptomatic bacteriuria in pregnancy. Cochrane Pregnancy and Childbirth Group. Cochrane Database Syst Rev.2019(11) Art. No. CD000490
  • 24. Siemefo Kamgang FDP, Maise HC, Moodley J. Pregnant women admitted with urinary tract infections to a public sector hospital in South Africa: Are there lessons to learn? S Afr J Infect Dis. 2016;31(3):79-83.
  • 25. Bakhtiari R, Dallal MS, Mehrabadi JF, Heidarzadeh S, Pourmand MR. Evaluation of culture and PCR methods for diagnosis of group B streptococcus carriage in Iranian pregnant women. Iran J Public Health. 2012;41(3):65-70
  • 26. Lee J, Chew KL, Charan N, Chan YH, Lin RTP, Yong EL. Preventing early-onset group B streptococcal sepsis: clinical risk factor-based screening or culture-based screening? Singapore Med J 2019.
  • 27. Unlu BS, Yidiz Y, Kaba M, et al. Urinary tract infection in pregnant population, which empirical antimicrobial agent should be specified in each of the three trimesters?. Ginekol Pol. 2014;85(5):371-376.
  • 28. Mithal LB, Shah N, Romanova A, Miller ES. Antenatal Screening for Group B Streptococcus in the Setting of Preterm Premature Rupture of Membranes: Empiric versus Culture-based Prophylaxis. Am J Perinat. 2020;10(01):26-31.
  • 29. Keating GM. Fosfomycin trometamol: a review of its use as a single-dose oral treatment for patients with acute lower urinary tract infections and pregnant women with asymptomatic bacteriuria. Drugs. 2013;73(17):1951-1966
  • 30. Wagenlehner FM, Schmiemann G, Hoyme U, et al. National S3 guideline on uncomplicated urinary tract infection: recommendations for treatment and management of uncomplicated community-acquired bacterial urinary tract infections in adult patients. Der Urologe Ausg A. 2011;50(2):153-169.

Erken Doğum Tehdidi Olan Gebelerde İdrar ve Rektovajinal Kültür Sonuçlarının Retrospektif Olarak Değerlendirilmesi

Year 2020, , 66 - 71, 12.12.2020
https://doi.org/10.46332/aemj.715833

Abstract

Amaç: Doğum eyleminin 20 0/7 ile 36 6/7 gebelik haftaları arasında başlamasına erken doğum tehdidi denir. En önemli sebeplerinden biri ürogenital enfeksiyonlardır. Bu çalışmada erken doğum tehdidi ile ürogenital enfeksiyonlar arasındaki ilişkinin araştırılması amaçlanmıştır.


Araçlar ve Yöntem: Ekim 2018-Ekim 2019 tarihleri arasında erken doğum tehdidi sebebiyle Kadın Hastalıkları ve Doğum servisine yatırılan 49 adet gebe çalışmaya dahil edildi. Her hastaya jinekolojik muayene yapıldı ve mikrobiyolojik inceleme için idrar ve rektovajinal sürüntü örnekleri alındı. Elde edilen veriler bir veri tabanında toplandı ve analiz edildi.


Bulgular: Hastaların %24.5’inde vajinal kültürde (n=12), %16.3’ünde idrar kültüründe (n=8), %6.1’inde rektal kültürde (n=3) üreme oldu. Vajen kültürü sonuçları; 5 adet vajinal kandidiyazis (Candida albicans), 3 adet Grup B streptokok, 2 adet bakteriyel vajinozis (Gardnerella vaginalis), 2 adet Trichomanas vaginalis, idrar kültürü sonuçları; 5 adet Escherichia coli, 2 adet Staphylococcus aureus, 1 adet Proteus mirabilis, rektal kültür sonuçları; 3 adet rektovajinal grup B streptokok idi. Kültürde üremesi olan ve uygun antibiyoterapi ile tedavi edilen 20 hastanın 1’inde erken doğum gözlendi.


Sonuç: Erken doğum tehdidi olan hastalarda idrar ve rektovajinal kültür yapılıp belirlenen patojene göre uygun tedavi verilmesi doğum eyleminin ilerlemesini engellemek için atılacak en önemli adımdır.

References

  • 1. Beck S, Wojdyla D, Say L, et al. The worldwide incidence of preterm birth: a systematic review of maternal mortality and morbidity. Bull World Health Organ. 2010;88:31-38
  • 2. Suman V, Luther EE. Preterm labor. Stat Pearls. StatPearls Publishing; 2019.
  • 3. Armson AB. Preterm labor. Vincenzo Berghella, editors. Obstetric Evidence-Based Guidelines. 3. Ed., Philadelphia, CRC Press; 2017:213-227
  • 4. Sameshima H, Saito S, Matsuda Y, et al. Annual report of the Perinatology Committee, Japan Society of Obstetrics and Gynecology, 2016: Overall report on a comprehensive retrospective study of obstetric management of preterm labor and preterm premature rupture of the membranes. J Obstet Gynaecol Res. 2018;4(1):5-12.
  • 5. American College of Obstetricians and Gynecologists. Practice Bulletin No. 171: Management of Preterm Labor. Obstet Gynecol. 2016;128(4):155-164
  • 6. Lockwood CJ. Predicting premature delivery- no easy task. N Eng J Med. 2002;346(4):282–284.
  • 7. Balkaya NA, Vural G, Eroğlu K. Gebelikte belirlenen risk faktörlerinin anne ve bebek sağlığı açısından ortaya çıkardığı sorunlar. Düzce Tıp Fak Derg. 2014;1(1):6-16.
  • 8. Giraldo PC, Araújo ED, Junior JE, Amaral RLGD, Passos MR, Gonçalves AK. The prevalence of urogenital infections in pregnant women experiencing preterm and full-term labor. Infect Dis Obstet Gynecol. 2012. Article ID: 878241
  • 9. Bianchi-Jassir F, Seale AC, Kohli-Lynch M, et al. Preterm birth associated with group B Streptococcus maternal colonization worldwide: systematic review and meta-analyses. Clin Infect Dis. 2017;65(2):133-142.
  • 10. Koutarou D. Multiple Mechanisms of Preterm Labor Other Than Intrauterine Infection. Hiroshi Sameshima, editor. Preterm Labor and Delivery. Singapore:Springer;2020:89-94 11. Klinik örnekten sonuç raporuna uygulama rehberi, Genital Sistem Örnekleri KLİMUD, Çağhan Ofset Matbaacılık Ltd. Şti. 2015, Erişim linki: https://www.klimud.org/public/ uploads/files/genital-sistem-ornekleri.pdf. Erişim tarihi: 7 Nisan, 2020.
  • 12. Machado A, Castro J, Cereija T, Almeida C, Cerca N. Diagnosis of bacterial vaginosis by a new multiplex peptide nucleic acid fluorescence in situ hybridization method. Peer J. 2015;3:e780.
  • 13. Machado D, Castro J, Martinez-de-Oliveira J, Nogueira-Silva C, Cerca, N. Prevalence of bacterial vaginosis in Portuguese pregnant women and vaginal colonization by Gardnerella vaginalis. Peer J. 2017;5:e3750.
  • 14. Sabour S, Arzanlou M, Vaez H, Rahimi G, Sahebkar A, Khademi F. Prevalence of bacterial vaginosis in pregnant and non-pregnant Iranian women: a systematic review and meta-analysis. Arch Gynecol Obstet. 2018;297(5):1101-1113.
  • 15. Martin DH, Zozaya M, Lillis RA, Myers L, Nsuami MJ, Ferris MJ. Unique Vaginal Microbiota That Includes an Unknown Mycoplasma-Like Organism Is Associated with Trichomonas vaginalis Infection. J Infect Dis. 2013;207(12):1922–1931.
  • 16. Rowley J, Vander Hoorn S, Korenromp E, et al. Chlamydia, gonorrhoea, trichomoniasis and syphilis: global prevalence and incidence estimates, 2016. Bull World Health Organ. 2019;97(8):548-562.
  • 17. Kwatra G, Cunnington MC, Merrall E., et al. Prevalence of maternal colonisation with group B streptococcus: a systematic review and meta-analysis. Lancet Infect Dis. 2016;16(9):1076-1084.
  • 18. Alp F, Findik D, Dagi HT, Arslan U, Pekin AT, Yilmaz SA. Screening and genotyping of group B streptococcus in pregnant and non-pregnant women in Turkey. J Infect Dev Ctries. 2016;10(3):222-226.
  • 19. Gonçalves B, Ferreira C, Alves CT, Henriques M, Azeredo J, Silva S. Vulvovaginal candidiasis: Epidemiology, microbiology and risk factors. Crit Rev Microbiol. 2016;42(6):905-927.
  • 20. Sutaria P, Cholera M, Donga SB. A prevalence study of vaginal candidiasis among pregnant women. Int J Adv Med. 2019;6(3):922-926.
  • 21. Rogozinska E, Formina S, Zamora J, et al. Accuracy of onsite tests to detect asymptomatic bacteriuria in pregnancy: a systematic review and meta-analysis. Obstet Gynecol. 2016;128(3):495-503.
  • 22. Kalinderi K, Delkos D, Kalinderis M, Athanasiadis A, Kalogiannidis I. Urinary tract infection during pregnancy: current concepts on a common multifaceted problem. J Obstet Gynaecol. 2018;38(4):448-453.
  • 23. Fiona M Smaill, Juan C Vazquez. Antibiotics for asymptomatic bacteriuria in pregnancy. Cochrane Pregnancy and Childbirth Group. Cochrane Database Syst Rev.2019(11) Art. No. CD000490
  • 24. Siemefo Kamgang FDP, Maise HC, Moodley J. Pregnant women admitted with urinary tract infections to a public sector hospital in South Africa: Are there lessons to learn? S Afr J Infect Dis. 2016;31(3):79-83.
  • 25. Bakhtiari R, Dallal MS, Mehrabadi JF, Heidarzadeh S, Pourmand MR. Evaluation of culture and PCR methods for diagnosis of group B streptococcus carriage in Iranian pregnant women. Iran J Public Health. 2012;41(3):65-70
  • 26. Lee J, Chew KL, Charan N, Chan YH, Lin RTP, Yong EL. Preventing early-onset group B streptococcal sepsis: clinical risk factor-based screening or culture-based screening? Singapore Med J 2019.
  • 27. Unlu BS, Yidiz Y, Kaba M, et al. Urinary tract infection in pregnant population, which empirical antimicrobial agent should be specified in each of the three trimesters?. Ginekol Pol. 2014;85(5):371-376.
  • 28. Mithal LB, Shah N, Romanova A, Miller ES. Antenatal Screening for Group B Streptococcus in the Setting of Preterm Premature Rupture of Membranes: Empiric versus Culture-based Prophylaxis. Am J Perinat. 2020;10(01):26-31.
  • 29. Keating GM. Fosfomycin trometamol: a review of its use as a single-dose oral treatment for patients with acute lower urinary tract infections and pregnant women with asymptomatic bacteriuria. Drugs. 2013;73(17):1951-1966
  • 30. Wagenlehner FM, Schmiemann G, Hoyme U, et al. National S3 guideline on uncomplicated urinary tract infection: recommendations for treatment and management of uncomplicated community-acquired bacterial urinary tract infections in adult patients. Der Urologe Ausg A. 2011;50(2):153-169.
There are 29 citations in total.

Details

Primary Language Turkish
Subjects Clinical Sciences
Journal Section Original Articles
Authors

Özge Kömürcü Karuserci 0000-0003-3836-2958

Seyhun Sucu 0000-0001-6821-4070

Publication Date December 12, 2020
Published in Issue Year 2020

Cite

APA Kömürcü Karuserci, Ö., & Sucu, S. (2020). Erken Doğum Tehdidi Olan Gebelerde İdrar ve Rektovajinal Kültür Sonuçlarının Retrospektif Olarak Değerlendirilmesi. Ahi Evran Medical Journal, 4(3), 66-71. https://doi.org/10.46332/aemj.715833
AMA Kömürcü Karuserci Ö, Sucu S. Erken Doğum Tehdidi Olan Gebelerde İdrar ve Rektovajinal Kültür Sonuçlarının Retrospektif Olarak Değerlendirilmesi. Ahi Evran Med J. December 2020;4(3):66-71. doi:10.46332/aemj.715833
Chicago Kömürcü Karuserci, Özge, and Seyhun Sucu. “Erken Doğum Tehdidi Olan Gebelerde İdrar Ve Rektovajinal Kültür Sonuçlarının Retrospektif Olarak Değerlendirilmesi”. Ahi Evran Medical Journal 4, no. 3 (December 2020): 66-71. https://doi.org/10.46332/aemj.715833.
EndNote Kömürcü Karuserci Ö, Sucu S (December 1, 2020) Erken Doğum Tehdidi Olan Gebelerde İdrar ve Rektovajinal Kültür Sonuçlarının Retrospektif Olarak Değerlendirilmesi. Ahi Evran Medical Journal 4 3 66–71.
IEEE Ö. Kömürcü Karuserci and S. Sucu, “Erken Doğum Tehdidi Olan Gebelerde İdrar ve Rektovajinal Kültür Sonuçlarının Retrospektif Olarak Değerlendirilmesi”, Ahi Evran Med J, vol. 4, no. 3, pp. 66–71, 2020, doi: 10.46332/aemj.715833.
ISNAD Kömürcü Karuserci, Özge - Sucu, Seyhun. “Erken Doğum Tehdidi Olan Gebelerde İdrar Ve Rektovajinal Kültür Sonuçlarının Retrospektif Olarak Değerlendirilmesi”. Ahi Evran Medical Journal 4/3 (December 2020), 66-71. https://doi.org/10.46332/aemj.715833.
JAMA Kömürcü Karuserci Ö, Sucu S. Erken Doğum Tehdidi Olan Gebelerde İdrar ve Rektovajinal Kültür Sonuçlarının Retrospektif Olarak Değerlendirilmesi. Ahi Evran Med J. 2020;4:66–71.
MLA Kömürcü Karuserci, Özge and Seyhun Sucu. “Erken Doğum Tehdidi Olan Gebelerde İdrar Ve Rektovajinal Kültür Sonuçlarının Retrospektif Olarak Değerlendirilmesi”. Ahi Evran Medical Journal, vol. 4, no. 3, 2020, pp. 66-71, doi:10.46332/aemj.715833.
Vancouver Kömürcü Karuserci Ö, Sucu S. Erken Doğum Tehdidi Olan Gebelerde İdrar ve Rektovajinal Kültür Sonuçlarının Retrospektif Olarak Değerlendirilmesi. Ahi Evran Med J. 2020;4(3):66-71.

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