Department of Microbiology, Faculty of Medicine Universitas Indonesia, Ciptomangunkusumo Hospital, Jakarta, Indonesia.
Department of Obstetrics and Gynecology, Faculty of Medicine Universitas Indonesia, Ciptomangunkusumo Hospital, Jakarta, Indonesia.
Infect Dis Obstet Gynecol. 2020 Apr 21;2020:9681632. doi: 10.1155/2020/9681632. eCollection 2020.
Pregnant women are usually at risk of urinary tract infections (UTIs) such as asymptomatic bacteriuria. In the current multidrug-resistance era, appropriate diagnosis and treatment should be provided to avoid complications in pregnant women in developing countries, which have limited facilities, such as Indonesia. The aim of this study was to evaluate in vitro susceptibility tests. Urinary isolates were collected from 715 pregnant women who visited eight Community Health Centers in Jakarta, Indonesia, between 2015 and 2017. We identified bacterial uropathogens from samples that were positive for nitrite/leukocyte esterase (LE), using two types of VITEK cards. Since noncompliance among patients is a major problem, fosfomycin-trometamol 3 g single-dose sachets were given to the patients, and the side effects of the medication and neonatal outcomes were reported. Asymptomatic bacteriuria was found in 10.5% of the 715 pregnant women. was the most common etiological factor (26.7%), followed by (20%), (9.3%), (5.3%), (5.3%), (4%), (4%), and others. Out of 76 pregnant women who took fosfomycin-trometamol, two complained of diarrhea that subsided without medication and fever that responded to paracetamol. Neonatal outcomes showed 100% full-term and normal-weight babies. , including extended-spectrum beta-lactamase- (ESBL-) producing , was 100% susceptible to fosfomycin. Nitrite/LE test results are often used as evidence for empiric antibiotic administration for treating asymptomatic bacteriuria in pregnancy, but the diagnosis should be confirmed using culture tests. Based on in vitro susceptibility patterns and medication outcomes, fosfomycin-trometamol single dose could be administered to noncompliant UTI patients, including pregnant women.
孕妇通常面临尿路感染(UTI)的风险,如无症状菌尿。在当前的多药耐药时代,应在发展中国家(如印度尼西亚)为孕妇提供适当的诊断和治疗,以避免出现并发症,这些国家的设施有限。本研究旨在评估体外药敏试验。从 2015 年至 2017 年期间在印度尼西亚雅加达的 8 个社区卫生中心就诊的 715 名孕妇中收集了尿液分离株。我们使用两种 VITEK 卡从亚硝酸盐/白细胞酯酶(LE)阳性的样本中鉴定出细菌尿病原体。由于患者不遵医嘱是一个主要问题,我们给患者开了福司福明-托美丁 3g 单剂量小袋药,并报告了药物的副作用和新生儿结局。715 名孕妇中有 10.5%患有无症状菌尿。是最常见的病因(26.7%),其次是(20%)、(9.3%)、(5.3%)、(5.3%)、(4%)、(4%)和其他。在 76 名服用福司福明-托美丁的孕妇中,有 2 名抱怨腹泻,无需药物治疗即可缓解,有 1 名发热,对扑热息痛有反应。新生儿结局显示 100%足月和正常体重的婴儿。包括产超广谱β-内酰胺酶(ESBL)的在内的所有均对福司福明 100%敏感。亚硝酸盐/LE 试验结果常用于治疗妊娠无症状菌尿的经验性抗生素治疗,但应使用培养试验确认诊断。根据体外药敏模式和药物治疗结果,福司福明-托美丁单剂量可用于包括孕妇在内的不合规 UTI 患者。