Anti-microbial sensitivity of enterobacteria identified in community-acquired urinary tract infection in pregnant women in 9 Colombian hospitals
DOI:
https://doi.org/10.18597/rcog.928Keywords:
Urinary tract infections, pregnancy, enterobacteria, microbial drug resistance, betalactamasesAbstract
Objective: To identify sensitivity profiles of the main anti-microbial agents used in the management of community-acquired urinary tract infection in pregnant women, and to make the molecular characterisation in order to confirm the existence of bacterial resistance in this population group.
Materials and methods: Descriptive cross-sectional study that included pregnant women with community-acquired urinary tract infection requiring admission to hospital. They were part of a study conducted in the general population. The microbiological results of the urine cultures were analysed. Isolates of Escherichia coli, Klebsiella spp. And Proteus mirabilis were identified over a period of 12 months in 9 Colombian hospitals, and their sensitivity profiles were determined using microdilution broth and gradient diffusion tests, and the presence of extended spectrum beta-lactamases was characterised using microbiological and molecular methods. The sociodemographic and clinical characteristics of these patients are presented.
Results: Overall, 74 isolates were collected (64 E. coli, 7 Klebsiella spp. and 3 P. mirabilis isolates) in 73 patients. Prior use of antibiotics was documented in 58% of the patients. Resistance to ampicillin/sulbactam, cefazolin and ceftriaxone was 15.6%, 17.2% and 4.7%, respectively. There was extended spectrum beta-lactamase expression in three of the isolates, 2 of E. coli and 1 of Klebsiella spp. (3.1% E. coli and 14.3% Klebsiella spp.) One E. coli isolate expressed enzymes of the AmpC type.
Conclusion: The presence of resistant strains to antibiotics used as first-line empirical treatment and to third-generation cephalosporins was confirmed in enterobacteria responsible for community-acquired urinary tract infection in pregnant women, produced by type CTX M-15 and AmpC extended spectrum betalactamase enzymes.Author Biographies
Laura Cristina Nocua-Báez
Jorge Alberto Cortes-Luna
Departamento de Medicina Interna, Facultad de Medicina, Universidad Nacional de Colombia. Grupo de Investigación en Enfermedades Infecciosas, Facultad de Medicina, Universidad Nacional de Colombia, Bogotá (Colombia). jacortesl@unal.edu.co
Aura Lucía Leal-Castro
Grupo de Investigación en Enfermedades Infecciosas, Facultad de Medicina, Universidad Nacional de Colombia. Departamento de Microbiología, Facultad de Medicina, Universidad Nacional de Colombia, Bogotá (Colombia).
Gerson Fitzgerald Arias-León
Departamento de Medicina Interna, Facultad de Medicina, Universidad Nacional de Colombia. Servicio de Infectología, Hospital de Santa Clara, ESE, Bogotá (Colombia).
María Victoria Ovalle-Guerro
Grupo para el control de la resistencia bacteriana en Bogotá (GREBO), Bogotá (Colombia).
Sandra Yamile Saavedra-Rojas
Grupo para el control de la resistencia bacteriana en Bogotá (GREBO), Bogotá (Colombia).
Giancarlo Buitrago-Gutiérrez
Grupo para el control de la resistencia bacteriana en Bogotá (GREBO); Departamento de Cirugía, Facultad de Medicina, Universidad Nacional de Colombia, Bogotá (Colombia).
Javier Antonio Escobar-Pérez
Laboratorio de Genética Molecular Bacteriana, Universidad El Bosque, Bogotá (Colombia).
Betsy Castro-Cardozo
Laboratorio de Genética Molecular Bacteriana, Universidad El Bosque, Bogotá (Colombia).
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