无症状菌尿孕妇尿路病原体的细菌数量和抗菌药耐药性模式:与血糖状况的关系

IF 1.5 Q3 OBSTETRICS & GYNECOLOGY
Dalia Rafat , Anubha Agrawal , Shamsi Khalid , Asad U. Khan , Tabassum Nawab , Asfia Sultan
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引用次数: 0

摘要

目标抗菌素耐药性(AMR)是一个日益严重的全球性威胁,对孕产妇和胎儿的健康构成重大威胁。妊娠期糖尿病(GDM)会给孕妇带来双重麻烦,在增加各种感染性疾病风险的同时,还可能与抗菌药物产生关联。无症状菌尿(ASB)是妊娠期的常见问题,但迄今为止,明确研究 GDM 与 ASB 之间关系的研究很少,且结果相互矛盾。专门研究 GDM 与 ASB 妇女体内 AMR 关系的研究更是少之又少。检索有关疾病负担、致病病原体范围、其 AMR 模式以及孕妇相关风险因素的最新信息,对于阻止妊娠期 AMR 的指数式增长以及改善孕产妇和新生儿感染性疾病的预后至关重要。因此,本研究计划调查 ASBS 孕妇的血糖状况与当代细菌谱、抗菌药耐药性(AMR)及相关变量之间的关系。 研究设计这项前瞻性、基于医院的横断面研究在 320 名孕妇中进行,分为两组,即 GDM 和非 GDM。通过结构化问卷收集了有关社会人口学和临床特征的数据。采用推荐的培养方法,对干净的中段尿液样本进行调查,以确定是否存在重要的细菌性尿路病原体,并确定其 AMR 模式。主要分离菌株是大肠埃希菌,其次是肺炎克雷伯菌。51.35%的分离菌株存在AMR,23.65%的分离菌株存在耐多药(MDR)。与非 GDM 组相比,从 GDM 组分离出的尿路病原体中,总体 AMR、MDR 和 AMR 程度较高,但差异无统计学意义。通过确定 ASB 和 AMR 与高血糖的关系,我们的研究呼吁利用这种潜在的关系来阻止 AMR 的流行,改善对感染性疾病的管理,从而减轻对孕产妇和婴儿造成的不良后果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Bacterial abundance and antimicrobial resistance patterns of uropathogens among pregnant women with asymptomatic bacteriuria: Association with glycemic status

Objectives

Antimicrobial resistance (AMR), a growing global menace, poses a significant threat to maternal and fetal health. Gestational diabetes mellitus (GDM) causes double trouble in pregnancy, increasing the risk of a variety of infectious morbidities while also raising the possible association with AMR. Asymptomatic bacteriuria (ASB) is a common problem in pregnancy, but little research has been done to date explicitly examining the relationship between GDM and ASB and yielded conflicting results. Even fewer studies have specifically examined the relationship between GDM and AMR in women with ASB. Retrieving the most recent information on the disease burden, the range of causative pathogens, their patterns of AMR, and associated risk factors in pregnant women is crucial to stop the exponential rise in AMR in pregnancy and improve maternal and neonatal outcomes of infectious morbidities. Hence, this study was planned to investigate the association between glycemic status and the contemporary bacterial profile, antimicrobial resistance(AMR), and associated variables among pregnant women with ASB

Study design

This prospective, hospital-based, cross-sectional study was conducted among 320 pregnant women; divided into two groups, GDM and non-GDM. Data regarding sociodemographic and clinical characteristics were collected using a structured questionnaire. Clean-catch midstream urine samples were investigated for the presence of significant bacterial uropathogens and their AMR pattern was determined using recommended culture methods.

Results

We found ASB in 46.25% of study participants with significantly higher occurrence in the GDM group. Dominant isolates were Escherichia coli followed by Klebsiella pneumoniae. AMR was noted in 51.35% and multidrug resistance(MDR) in 23.65% of isolates. Overall AMR, MDR and higher degrees of AMR were higher among uropathogens isolated from the GDM group as compared to the non GDM group, although the difference was not statistically significant.

Conclusion

The high occurrence of ASB in pregnancy along with substantially high AMR in this study suggests the need for effective infection control and stewardship programmes. By defining the association of ASB and AMR with hyperglycemia, our study calls for the exploitation of this potential association in halting the pandemic of AMR and in improving the management of infectious morbidities, thus in-turn alleviating their undesired maternal and infant outcomes.

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