Pyuria, bacteriuria and empirical antibiotic selection in pregnant women

Abstract

Aims: In pregnancy, early diagnosis and proper treatment of urinary tract infections are crucial in preventing maternal and fetal comorbidities. Therefore, pregnant women should be screened for asymptomatic bacteriuria. This study aimed to evaluate the relationship between pyuria and bacteriuria and the susceptibility of uropathogens, as well as to review the empiric drug options for pregnant women. Methods: The presence of pyuria and bacteriuria in urine samples obtained from the pregnant outpatient clinic between January 2023 and December 2023 at Kırıkkale University Faculty of Medicine Hospital’s Infectious Diseases and Clinical Microbiology Laboratory was investigated. Uropathogens were identified and typed using the BD Phoenix™ M50 automated system for bacterial identification and antibiotic susceptibility testing, and antibiotic susceptibility was interpreted according to the European Committee on Antimicrobial Susceptibility Testing criteria. Results: A total of 1457 urine samples were evaluated in this retrospective study. Uropathogens were detected in 235 patients, while 301 samples were considered contaminated. Uropathogens were found to be susceptible to amoxicillin-clavulanate, trimethoprim-sulfamethoxazole, nitrofurantoin, and fosfomycin, in that order, for use in pregnant women. High resistance rates to third-generation cephalosporins were observed. Conclusion: According to the results of this study, local resistance rates against urinary pathogens in pregnant women should be determined at specific intervals, and empirical antibiotic therapy should be planned based on these data.

Keywords

• Asymptomatic bacteriuria
• urinary tract infection
• empirical antibiotherapy

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