Urinary Tract Infections in Antenatal and Postnatal Women: Pathogen Profiles, Antibiotic Sensitivity Patterns, and Labor Outcomes at a Secondary Care Hospital in South India – A 3-year Retrospective Observational Study

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Abstract Background: Urinary tract infection is a common problem in antenatal women, associated with serious morbidity in mother and baby. This study aims to describe the uropathogen profile noted in pregnant women visiting a secondary hospital in Southern India and the antimicrobial susceptibility pattern. This would be useful in the selection of antimicrobial agents for the initiation of empirical antibiotic therapy. Methods: A retrospective observational study was performed on data collected from 2017 to 2020. Urine cultures were performed on symptomatic pregnant women, those who were positive by a screening test, or those who had a history of previous preterm labor or preterm rupture of membranes. A total of 575 urine cultures had been performed in this period. Results: A total of 183 of the 575 (31.8%) samples sent for urine culture showed significant growth. The most common organism grown was Escherichia coli (45.1%), followed by Klebsiella spp. (15.6%) and Enterococcus spp. (7.8%). Among th e E . coli , 20% were extended-spectrum beta-lactamase producers. E. coli was susceptible to amoxicillin–clavulanate (88%), gentamicin (88%), and nitrofurantoin (82%). Klebsiella spp. was susceptible to cefpodoxime and cotrimoxazole (92.3% each) and amoxicillin–clavulanate (84.6% each). There were no significant differences in perinatal outcomes between the patients who were culture positive and those who were culture negative. Conclusion: The absence of significant growth in 68% of specimens sent underlines the importance of microbiological testing before antibiotic administration. The most common organisms noted in our study population were E . coli , followed by Klebsiella . Amoxicillin–clavulanate, gentamicin, ciprofloxacin, and nitrofurantoin were noted to be good options for antimicrobial therapy.

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