Global View of Urinary Tract Drug-Resistant Infections in Pregnant Women: A Systematic Review and Meta-Analysis
60 Pages Posted: 28 Sep 2019More...
Introduction: Urinary tract infection is one of the most common health problems and hazardous factor among pregnant women. Different microorganisms are contributing in the bacteriuria which by emergence of drug resistance among Gram positive and Negative therapeutic option is very limited. This study is aim to assess the global danger of urinary tract drug-resistant infections in pregnant women.
Methods: This meta-analysis which was registered by a pre-defined protocol in PROSPRO carried out in accordance with PRISMA guideline. All international databases were search by English MeSH keywords.
Results: A total of 48 from 2005 screened studies that fulfilled the inclusion criteria were selected. In total, E.coli, Klebsiella sp., P. aeruginosa, S. aureus detected as the most common pathogens in UTI's. Results of this analysis demonstrated different resistance rate against studied classes of antibiotics. Nitrofurantoin resistance in E.coli, Klebsiella sp., P. aeruginosa and Staphylococcus aureus isolates were estimated 0.22 (95%CI: 0.15 - 0.30), 0.40 (95%CI: 0.26 - 0.54), 0.81 (95%CI: 0.59-0.97), 0.34 (0.11- 0.63) respectively. Subgroups analysis showed highest resistance in E. coli isolates, in Asia and Africa against Cefotaxim and Ampicillin respectively. Highest resistance in Asia and Africa were related to Ampicillin and Cefotaxime in Klebsiella isolates.
Conclusion: In summary, increasing resistance rate in UTI related agents is a risk factor that endangers both mother and fetus. Health care providers should consider screening as the radical part of infection control strategies. Due to low resistance rate to Nitrofurantoin, this drug can be a good choice for UTI treatment in pregnancies, but it should use with caution.
Funding Statement: The authors stated: "No funding."
Declaration of Interests: The authors declared: "No."
Ethics Approval Statement: The study was registered prospectively by a pre-defined protocol (PROSPERO No: CRD42019133729).
Keywords: Urinary tract infection, Pregnancy, Meta-analysis
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