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加纳北部地区一家初级卫生保健机构中接受产前护理的孕妇的尿路感染及相关因素

Urinary Tract Infection and Associated Factors among Pregnant Women Receiving Antenatal Care at a Primary Health Care Facility in the Northern Region of Ghana.

作者信息

Vicar Ezekiel K, Acquah Samuel E K, Wallana Williams, Kuugbee Eugene D, Osbutey Emmanuel K, Aidoo Abigail, Acheampong Emmanuel, Mensah Gloria Ivy

机构信息

Department of Clinical Microbiology, School of Medicine, University for Development Studies, Tamale, Northern Region, Ghana.

Department of Infectious Diseases, School of Allied Health Science, University for Development Studies, Tamale, Northern Region, Ghana.

出版信息

Int J Microbiol. 2023 Jun 2;2023:3727265. doi: 10.1155/2023/3727265. eCollection 2023.

Abstract

Urinary tract infection (UTI) is frequently encountered during pregnancy and is associated with adverse maternal, fetal, and neonatal effects. However, very little information is available on the prevalence of UTI among pregnant women in the northern part of Ghana, a region with a high birth rate. This study employed a cross-sectional analysis of the prevalence, antimicrobial profile, and risk factors associated with UTI in 560 pregnant women attending primary care for antenatal check-ups. Sociodemographic obstetrical history and personal hygiene information were obtained using a well-structured questionnaire. Afterward, clean catch mid-stream urine samples were collected from all participants and subjected to routine microscopy examination and culture. Of 560 pregnant women, 223 cases (39.8%) were positive for UTI. There was a statistically significant association between sociodemographic, obstetric, and personal hygiene variables and UTI ( < 0.0001). (27.8%) was the commonest bacterial isolate followed by CoNS (13.5%) and (12.6%). These isolates exhibited greater resistance to ampicillin (70.1-97.3%) and cotrimoxazole (48.1-89.7%) but were fairly susceptible to gentamycin and ciprofloxacin. Gram-negative resistance to meropenem was up to 25.0%, and Gram positives resistance to cefoxitin and vancomycin was up to 33.3% and 71.4% respectively. The current findings extend our knowledge of the high frequency of UTIs and associated risk factors in pregnant women with being the predominant and usual isolate. Variation existed in the resistance pattern of isolates to various drugs, underscoring the need to perform urine culture and susceptibility before treatment.

摘要

尿路感染(UTI)在孕期较为常见,且与孕产妇、胎儿及新生儿的不良影响相关。然而,关于加纳北部这一高出生率地区孕妇中UTI患病率的信息却非常少。本研究采用横断面分析方法,对560名前来初级保健机构进行产前检查的孕妇中UTI的患病率、抗菌谱及相关危险因素进行了研究。通过一份结构完善的问卷获取了社会人口统计学、产科病史及个人卫生信息。随后,从所有参与者中收集清洁中段尿样本,进行常规显微镜检查和培养。在560名孕妇中,223例(39.8%)UTI检测呈阳性。社会人口统计学、产科及个人卫生变量与UTI之间存在统计学显著关联(<0.0001)。大肠埃希菌(27.8%)是最常见的细菌分离株,其次是凝固酶阴性葡萄球菌(13.5%)和克雷伯菌属(12.6%)。这些分离株对氨苄西林(70.1 - 97.3%)和复方新诺明(48.1 - 89.7%)表现出较高耐药性,但对庆大霉素和环丙沙星相当敏感。革兰阴性菌对美罗培南的耐药率高达25.0%,革兰阳性菌对头孢西丁和万古霉素的耐药率分别高达33.3%和71.4%。当前研究结果扩展了我们对孕妇中UTI高发生率及相关危险因素的认识,其中大肠埃希菌是主要且常见的分离株。分离株对各种药物的耐药模式存在差异,这突出了在治疗前进行尿培养和药敏试验的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/440d/10256441/7e1505d361c1/IJMICRO2023-3727265.001.jpg

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