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1.
S Afr Med J ; 110(9): 872-876, 2020 Aug 31.
Artigo em Inglês | MEDLINE | ID: mdl-32880271

RESUMO

BACKGROUND: Urinary tract infection (UTI) is one of the most common infections during pregnancy, which can lead to significant maternal and perinatal morbidity and mortality if left untreated. Challenges when treating UTIs in pregnancy include fetal protection and resistance development of uropathogens. Currently, the Essential Medicines List recommends nitrofurantoin to treat cystitis and ceftriaxone to treat pyelonephritis in pregnant women. OBJECTIVES: To determine common pathogens causing UTI in pregnancy and their antibiotic susceptibility patterns. METHODS: A retrospective analysis was performed of laboratory data for positive urine specimens from obstetric departments of 6 KwaZulu- Natal Province hospitals during 2011 - 2016. Identification and susceptibility testing were performed using the VITEK 2 system. Results were interpreted according to the breakpoints of the Clinical and Laboratory Standards Institute, USA. RESULTS: From 5 971 positive urine specimens, the most common isolate was Escherichia coli (n=3 236; 54.2%), followed by Klebsiella pneumoniae (n=770; 12.9%). Group B streptococcus (GBS) (n=239; 4.0%) and Enterococcus faecalis (n=251; 4.2%) were the most common Gram-positive pathogens. E. coli displayed significant resistance to trimethoprim-sulfamethoxazole (65.1%), cephalothin (38.3%), cefuroxime (27.3%), ciprofloxacin (16.9%) and amoxicillin-clavulanic acid (17.1%). Resistance to ceftriaxone and nitrofurantoin remained low ‒ 9.1% and 7.7%, respectively. Among Gram-positive pathogens, GBS displayed 100% penicillin susceptibility and E. faecalis showed 92.9% susceptibility to ampicillin. CONCLUSIONS: E. coli is unsurprisingly the most common cause of UTI in pregnancy in KwaZulu-Natal. Susceptibility to ceftriaxone and nitrofurantoin remains good. Among Gram positives, GBS is prevalent and susceptible to penicillin, while E. faecalis is susceptible to ampicillin. As antimicrobial resistance evolves, routine surveillance is necessary to modify recommended empirical antibiotic use.


Assuntos
Antibacterianos/farmacologia , Infecções Bacterianas/microbiologia , Bactérias Gram-Negativas/efeitos dos fármacos , Bactérias Gram-Positivas/efeitos dos fármacos , Complicações Infecciosas na Gravidez/microbiologia , Infecções Urinárias/microbiologia , Candida albicans/isolamento & purificação , Enterococcus faecalis/efeitos dos fármacos , Enterococcus faecalis/isolamento & purificação , Escherichia coli/efeitos dos fármacos , Escherichia coli/isolamento & purificação , Feminino , Bactérias Gram-Negativas/isolamento & purificação , Bactérias Gram-Positivas/isolamento & purificação , Humanos , Klebsiella pneumoniae/isolamento & purificação , Testes de Sensibilidade Microbiana , Gravidez , Proteus mirabilis/isolamento & purificação , Estudos Retrospectivos , África do Sul , Streptococcus agalactiae/efeitos dos fármacos , Streptococcus agalactiae/isolamento & purificação , Urina/microbiologia
3.
Genitourin Med ; 71(2): 65-7, 1995 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-7744414

RESUMO

OBJECTIVE: The aim of this study was to assess the prevalence of syphilis, human immunodeficiency virus (HIV), and hepatitis B virus (HBV) infections in women at the time of delivery, and to determine the seroconversion rates for syphilis and HIV infections from initial booking visit to delivery. SETTING: The labour ward of a typical tertiary hospital in a developing country and serving an indigent African population. METHOD: Four hundred and eighteen women presenting in labour were randomly selected and informed consent obtained for serological testing for syphilis and HBV infections in umbilical cord blood samples. The specimens were then given a study number, the gestational ages recorded and anonymously tested for HIV infection. RESULTS: Of the 191 women who had antenatal care, 13 (6.8%) were HIV antibody positive at the initial "booking" visit. An additional 4 were found to be HIV antibody positive at the time of delivery resulting in a seroconversion rate of 2.2%. The seroconversion rate for syphilis at the time of delivery was 2.7%. Hepatitis B surface antigens were detected in only 2 women, one of whom was antigen positive. CONCLUSION: The high seroconversion rates for both syphilis and HIV infection in pregnancy justifies re-screening for these conditions in endemic areas such as ours.


Assuntos
Soropositividade para HIV/epidemiologia , Complicações Infecciosas na Gravidez/epidemiologia , Sífilis/epidemiologia , Parto Obstétrico , Feminino , Sangue Fetal/imunologia , Anticorpos Anti-HIV/análise , Soroprevalência de HIV , Hepatite B/epidemiologia , Antígenos de Superfície da Hepatite B/análise , Humanos , Recém-Nascido , Programas de Rastreamento , Gravidez , Cuidado Pré-Natal , Prevalência , Sífilis Congênita/prevenção & controle , Fatores de Tempo
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