埃塞俄比亚亚的斯亚贝巴选定医疗机构孕妇尿路感染、耐药性和胎儿结局:一项横断面研究设计

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摘要

背景:尿路感染(UTI)是孕妇常见的健康问题。未经治疗的尿路感染可能导致胎儿并发症,如早产、低出生体重、子宫内生长迟缓和宫内胎儿死亡。细菌病原体的主要问题之一是它们产生耐药性的能力。确定尿路细菌的药敏模式有助于确定有效的药物,并尽量减少进一步的不良围产期结局。本研究的目的是描述孕妇的程度和耐药概况和相关的胎儿结局。方法:于2019年3月至6月进行横断面研究。研究对象的社会人口学数据是在征得参与者完全同意后通过结构化问卷的方式收集的。从研究参与者身上收集干净的中游尿液,并用螺旋盖容器将样本运送到实验室。用血液和麦康基琼脂培养尿液样本中的细菌。细菌菌落的分离和鉴定使用标准的生化性质。采用抗生素片对Muller-Hinton琼脂进行药敏试验。分娩时,将婴儿出生体重和胎龄记录在日志簿上,作为日常工作的一部分。从日志中记录胎儿结局数据,输入EPI数据管理软件,然后转入SPSS进行分析。结果:在处理的424份尿样中,63份(14.9%)产生明显的细菌尿。63例尿路感染中59例(93.7%)发生在15-34岁年龄组。大肠杆菌、肺炎克雷伯菌和金黄色葡萄球菌是三种优势分离菌。革兰氏阴性菌对氨苄西林和头孢他啶耐药最多(43.2%),革兰氏阳性菌对四环素耐药最多(36.8%)。本研究结果显示,UTI与宫内胎儿死亡(IUFD)和胎膜早破(PROM)的发生有统计学意义(P< 0.05)。结论:不良胎儿结局与妊娠期尿路感染存在显著相关。如果对母亲进行早期诊断和治疗,这种情况是可以控制的
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Urinary Tract Infection, Drug Resistance Profile And Fetal Outcomes Among Pregnant Women In Selected Health Facilites Of Addis Ababa, Ethiopia: A CrossSectional Study Design
Background: Urinary tract infection (UTI) is a commonly encountered health problem among pregnant women. Untreated UTI may result in fetal complications like preterm birth, low birth weight, intra uterine growth retardation and intrauterine fetal death. One of the major problems with bacterial pathogens is their ability to develop drug resistance. Determining drug susceptibility pattern of bacteria from urinary tract helps to identify effective drugs and minimize further adverse perinatal outcomes. The purpose of this study was to describe the magnitude and drug resistance profile of pregnant women and related fetal outcomes. Methods:A cross-sectional study was conducted from March to June 2019. Socio-demographic data of the study participants was collected by administering structured questionnaire after obtaining full consent of the participants. Clean catch mid-stream urine was collected from the study participants and the samples were transported to the laboratory with screw-capped container. Blood and MacConkey agar were used to cultivate bacteria from urine sample. Bacterial colonies were isolated and identified using standard biochemical properties. Antibacterial susceptibility test was done on Muller-Hinton agar using antibiotic discs. At the time of delivery, infant’s birth weight and gestational age was recorded on the log book as part of the daily work. Fetal outcome data were recorded from the log book and entered to EPI data management software then transferred to SPSS for analysis. Results:Out of 424 urine samples processed, 63 (14.9%) yielded significant bacteriuria. Fifty-nine out of 63 (93.7%) cases of UTIs were recorded among age group of 15-34 years. Escherichia coli, Klebsiellapneumoniae, and Staphylococcus aureus were the three dominant bacterial isolates. Most of the gram negative bacterial isolates were resistant to ampicillin and ceftazidime (43.2% each) while gram positive was resistant for tetracycline (36.8%). The result of this study showed that UTI had statistical association with the occurrence of Intrauterine Fetal Death (IUFD) and Prerupture of Membrane (PROM) (P<.05). Conclusion: Adverse fetal outcomes are significantly linked with the presence of UTI during pregnancy. The condition can be managed if early diagnosis and treatments are made for the mother
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