Antimicrobial susceptibility of Gram-negative uropathogens isolated from obstetric patients.
OBJECTIVE
To evaluate the antimicrobial susceptibility of Gram-negative uropathogens isolated from pregnant women.


METHODS
We performed a snapshot cohort study of women receiving care in the University of Florida prenatal clinics during March 2000. Subjects with asymptomatic bacteriuria or cystitis were identified and the antimicrobial susceptibility of each pathogen was recorded. Data were analyzed using chi-square, Fisher's exact test and ninety-five percent confidence intervals, as appropriate.


RESULTS
Ninety-five positive cultures were identified. Isolates were more often susceptible to trimethoprim-sulfamethoxazole (TMP-SMX) (87%) and nitrofurantoin (89%) than to ampicillin (72%) (p < 0.03). Escherichia coli accounted for 71 (75%) cases and was more often susceptible to nitrofurantoin (100%) than to TMP-SMX (87%) (p < 0.01). Proteus isolates were all susceptible to TMP-SMX and resistant to nitrofurantoin (p < 0.01).


CONCLUSIONS
Both TMP-SMX and nitrofurantoin are superior to ampicillin for empiric treatment of lower urinary tract infection in pregnant women. Nitrofurantoin is superior to TMP-SMX for treatment of infections caused by E. coli. For suspected or confirmed cases caused by Proteus organisms, TMP-SMX is the preferred agent.
Jamie
Whitney E
WE
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Florida College of Medicine, Gainesville, FL 32610-0294, USA. jamiewe@obgyn.ufl.edu
Edwards
Rodney K
RK
Duff
Patrick
P
D000328:Adult; D000667:Ampicillin / Q000494:pharmacology; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D015331:Cohort Studies; D003556:Cystitis / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*; D005260:Female; D005431:Florida / Q000453:epidemiology; D005865:Gestational Age; D006090:Gram-Negative Bacteria / Q000187:drug effects* / Q000302:isolation & purification*; D006801:Humans; D008826:Microbial Sensitivity Tests; D009582:Nitrofurantoin / Q000494:pharmacology; D009774:Obstetrics; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis* / Q000188:drug therapy; D011295:Prenatal Care / Q000379:methods; D012680:Sensitivity and Specificity; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000494:pharmacology; D016482:Urinalysis; D014556:Urine / Q000382:microbiology
D000900:Anti-Bacterial Agents; D000667:Ampicillin; D015662:Trimethoprim, Sulfamethoxazole Drug Combination; D009582:Nitrofurantoin