Antimicrobial resistance among pregnant women with urinary tract infections is on rise: Findings from meta-analysis of observational studies

J Infect Public Health. 2024 Jul;17(7):102467. doi: 10.1016/j.jiph.2024.05.055. Epub 2024 May 31.

Abstract

Pregnant women have a higher risk of urinary tract infections (UTIs) compared to non-pregnant women, making antibiotics necessary for treatment. However, prescribing antibiotics without culture and sensitivity tests may contribute to antimicrobial resistance. A meta-analysis using R was conducted to determine the prevalence of antibiotic resistance patterns in UTIs among pregnant women. We identified observational studies published in the last 10 years and used a random effects model to calculate the pooled prevalence. The prevalence of Gram-negative organisms causing UTIs in pregnant women was 67 %, while Gram-positive organisms were 22 %. The burden of Gram-positive organisms exhibiting antimicrobial resistance was very high at 95 %, primarily to ampicillin. The most common Gram-negative organisms exhibiting antimicrobial resistance were E. coli, Klebsiella, and Pseudomonas aeruginosa, while the most common Gram-positive organisms resistant to antibiotics were Staphylococcus aureus and coagulase-negative Staphylococcus. Sensitivity and culture testing are recommended for effective treatment in pregnant women with UTIs.

Keywords: Antimicrobial resistance; Meta-analysis; Pregnant women; Urinary tract infections.

Publication types

  • Meta-Analysis
  • Review

MeSH terms

  • Anti-Bacterial Agents* / pharmacology
  • Anti-Bacterial Agents* / therapeutic use
  • Drug Resistance, Bacterial*
  • Female
  • Gram-Negative Bacteria / drug effects
  • Gram-Negative Bacteria / isolation & purification
  • Gram-Positive Bacteria / drug effects
  • Gram-Positive Bacteria / isolation & purification
  • Humans
  • Microbial Sensitivity Tests
  • Observational Studies as Topic*
  • Pregnancy
  • Pregnancy Complications, Infectious* / drug therapy
  • Pregnancy Complications, Infectious* / epidemiology
  • Pregnancy Complications, Infectious* / microbiology
  • Prevalence
  • Urinary Tract Infections* / drug therapy
  • Urinary Tract Infections* / epidemiology
  • Urinary Tract Infections* / microbiology

Substances

  • Anti-Bacterial Agents