Diagnostic and treatment difficulties of pyelonephritis in pregnancy in resource-limited settings

• المؤلفون الرئيسيون: Rose McGready, Vanaporn Wuthiekanun, Elizabeth A. Ashley, Saw Oo Tan, Mupawjay Pimanpanarak, Samuel Jacher Viladpai-nguen, Wilarat Jesadapanpong, Stuart D. Blacksell, Stephane Proux, Nicholas P. Day, Pratap Singhasivanon, Nicholas J. White, François Nosten, Sharon J. Peacock
• مؤلفون آخرون: Shoklo Malaria Research Unit
• التنسيق: مقال
• منشور في: 2018
• الموضوعات: Immunology and Microbiology; Medicine
• الوصول للمادة أونلاين: https://repository.li.mahidol.ac.th/handle/123456789/29166
• المؤسسة: Mahidol University

Limited microbiology services impede adequate diagnosis and treatment of common infections such as pyelonephritis in resource-limited settings. Febrile pregnant women attending antenatal clinics at Shoklo Malaria Research Unit were offered urine dipstick, sediment microscopy, urine culture, and a 5-mL blood culture. The incidence of pyelonephritis was 11/1,000 deliveries (N = 53 in 4,819 pregnancies) between January 7,2004 and May 17,2006. Pyelonephritis accounted for 20.2% (41/203) of fever cases in pregnancy. Escherichia coli was the most commonly isolated pathogen: 87.5% (28/32) of organisms cultured. Susceptibility of E. coli to ampicillin (14%), cotrimoxazole (21%), and amoxicillin-clavulanic acid (48%) was very low. E. coli was susceptible to ceftriaxone and ciprofloxacin. The rate of extended spectrum β-lactamase (4.2%; 95% confidence interval = 0.7-19.5) was low. The rate and causes of pyelonephritis in pregnant refugee and migrant women were comparable with those described in developed countries. Diagnostic innovation in microbiology that permits affordable access is a high priority for resource-poor settings. Copyright © 2010 by The American Society of Tropical Medicine and Hygiene.