Infeções urinárias na gravidez

• Autor(a) principal: Gomes,Inês
• Data de Publicação: 2017
• Outros Autores: Metello,José, Freitas,Bruno, Diogo,José
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: http://scielo.pt/scielo.php?script=sci_arttext&pid=S1646-58302017000400004
• topic: Urinary tract infections; Pregnancy; Microbial sensitivity tests; Drug resistance; Microbial

Overview and Aims: Urinary tract infections (UTI) are frequent in pregnancy and are associated with increased preterm delivery and low birth weight. Asymptomatic bacteriuria (ABU) is the most common clinical entity and in the absence of treatment it can progress to pyelonephritis in 25% to 30% of the cases. The culture of a urine specimen is the gold standard for the diagnosis of UTI, being Escherichia coli the most common agent. The aim of this study is 1) to identify which are the main microbial agents of the urine cultures in a pregnant population, 2) to observe the agents' antibiotic resistance and sensitivity, 3) to investigate which are the best antimicrobials for the treatment of an UTI in pregnant women, and 4) to compare with a similar study conducted at the same hospital between 2005 and 2006 in order to analyze the evolution of the antimicrobial resistances pattern. Study design: Retrospective observational study. Population: 305 cases with positive urine cultures obtained in the obstetrics outpatient clinic of a tertiary care hospital, between January 2014 and December 2015. Results: E. coli was isolated in 48,9% of cases. Streptococcus agalactiae was identified in 18,4%, Klebsiella pneumoniae in 10,1% and Proteus mirabilis in 8,5%. The global antimicrobial resistance profile was: ampicillin 50%, nitrofurantoin 24%, cotrimoxazole 17%, cefalotin 11%, amoxicilin+clavulanate and gentamycin both 6%, cefuroxime 3%, ceftazidime ceftriaxone and piperacilin-tazobactam 0%. Conclusions: In our population, the most frequent agent was E. coli. Cefuroxime is a good choice as a first-line agent for empiric treatment. Ampicillin and cotrimoxazole presented both high global and E. coli specific resistance rates. Comparatively to 2005 and 2006, the resistances have increased for nitrofurantoin and decreased for amoxicilin+clavulanate