在布埃亚卫生区的一些综合卫生中心，参加 ANC 的孕妇中尿路感染的流行率、抗生素敏感性模式及相关危险因素。
Prevalence, antimicrobial susceptibility pattern and associated risk factors for urinary tract infections in pregnant women attending ANC in some integrated health centers in the Buea Health District.
机构信息
Department of Microbiology and Parasitology, Faculty of Science, University of Buea, South West Region, Buea, Cameroon.
出版信息
BMC Pregnancy Childbirth. 2021 Oct 4;21(1):673. doi: 10.1186/s12884-021-04142-4.
BACKGROUND
Urinary tract infections (UTIs) are the second most frequent infections after respiratory tract infections that affect humans, with over 150 million cases per year. The anatomy of the female urinary tract predisposes them to UTIs than men. More so, physiological and hormonal changes during pregnancy put pregnant woman at risk of UTIs. Untreated UTI(s) in pregnancy can be detrimental to both the mother and child causing preterm labour, low birth weight and pyelonephritis. The situation is worrisome because the infection can be asymptomatic. This study investigated the prevalence and risk factors for UTIs, diagnostic potential of dipstick analyses and antimicrobial susceptibility of uropathogens from pregnant women attending ANC in some Integrated Health Centers (IHCs) in Buea Health District (BHD).
METHODS
A structured questionnaire was administered to consenting pregnant women at participating IHCs to collect data on demographic characteristics, risk factors and symptoms of UTI. Urine samples were collected for dipstick analysis and culture. Antibiograms were performed on the isolates by the disc diffusion method. A bivariate analysis was performed to investigate the association of the risk factors to UTI. Chi square (χ) test, odds ratios with corresponding 95% confidence intervals were used to compare statistics and test for associations at a significant level of p ≤ 0.05.
RESULTS
Of the 287 participants recruited, 89(31%) were positive for UTI. There were 150 women with no symptoms of which 43(28.7%) were positive for UTI. E. coli was the most frequent (43.2%) of the organisms implicated in bacteriuria. There was no significant association between the risk factors studied and UTI. Isolates were most sensitive to ciprofloxacin (73.5%) and gentamycin (73.5%) and resistant to ceftriaxone (70.6%) and tetracycline (64.7%). Nitrite test was highly specific (100%) for the diagnosis of UTI while leucocyte esterase was more sensitive (48.3%) than specific (44.9%).
CONCLUSIONS
The prevalence of UTI in BHD was high. In conformity with previous findings in same area, there were no risk factors associated with UTI. We recommended a longitudinal study with a larger sample size to follow up the women to term in order to determine the gravity of this infection on pregnancy outcomes.
背景
尿路感染（UTI）是仅次于呼吸道感染的第二大常见人类感染，每年有超过 1.5 亿例病例。女性的尿路解剖结构使她们比男性更容易感染 UTI。此外，怀孕期间的生理和激素变化使孕妇容易感染 UTI。未经治疗的孕妇 UTI 可能对母婴双方都有害，导致早产、低出生体重和肾盂肾炎。这种情况令人担忧，因为感染可能没有症状。本研究调查了在布埃阿卫生区（BHD）一些综合卫生中心（IHC）接受 ANC 的孕妇中 UTI 的流行率和危险因素、尿试纸分析的诊断潜力以及尿路病原体的抗菌药物敏感性。
方法
在参与 IHC 的同意的孕妇中使用结构化问卷收集人口统计学特征、危险因素和 UTI 症状的数据。收集尿液样本进行尿试纸分析和培养。采用纸片扩散法对分离株进行抗生素谱分析。采用双变量分析调查危险因素与 UTI 的关联。使用卡方（χ）检验、比值比及其相应的 95%置信区间比较统计学数据，并在 p 值≤0.05 时进行关联检验。
结果
在招募的 287 名参与者中，89 名（31%）对 UTI 呈阳性。有 150 名无症状的女性中，有 43 名（28.7%）对 UTI 呈阳性。大肠杆菌是最常见的（43.2%）引起菌尿的病原体。在所研究的危险因素与 UTI 之间没有显著关联。分离株对环丙沙星（73.5%）和庆大霉素（73.5%）最敏感，对头孢曲松（70.6%）和四环素（64.7%）最耐药。亚硝酸盐试验对 UTI 的诊断具有高度特异性（100%），而白细胞酯酶的敏感性（48.3%）高于特异性（44.9%）。
结论
BHD 的 UTI 患病率很高。与该地区以前的发现一致，没有与 UTI 相关的危险因素。我们建议进行一项具有更大样本量的纵向研究，对这些女性进行随访至足月，以确定这种感染对妊娠结局的严重程度。
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