title: Urinary tract infection in pregnant population, which empirical antimicrobial agent should be specified in each of the three trimesters?
abstract: OBJECTIVE
  We aimed to investigate the bacterial profile and the adequacy of antimicrobial treatment in pregnant women with urinary tract infection.
  
  
  METHODS
  This retrospective observational study was conducted with 753 pregnant women who needed hospitalization because of UTI in each of the three trimesters. Midstream urine culture and antimicrobial susceptibility tests were evaluated.
  
  
  RESULTS
  E. Coli was the most frequently isolated bacterial agent (82.2%), followed by Klebsiella spp. (11.2%). In each of the three trimesters, E. Coli remained the most frequently isolated bacterium (86%, 82.2%, 79.5%, respectively), followed by Klebsiella spp. (9%, 11.6%, 12.2%, respectively). Enterococcus spp. were isolated as a third microbial agent, with 43 patients (5.7%) in the three trimesters. The bacteria were found to be highly sensitive to fosfomycin, with 98-99% sensitivity for E.Coli and 88-89% for Klebsiella spp. and for Enterococcus spp. 93-100% nitrofurantoin sensitivity for each of the three trimesters.
  
  
  CONCLUSIONS
  We demonstrated that E. Coli and Klebsiella spp. are the most common bacterial agents isolated from urine culture of pregnant women with UTI in each of the three trimesters. We consider fosfomycin to be the most adequate first-line treatment regimen due to high sensitivity to the drug, ease of use and safety for use in pregnancy
authors.forename: Bekir Serdar
authors.initials: BS
authors.lastname: Unlu
authors.forename: Yunus
authors.initials: Y
authors.lastname: Yildiz
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Keles
authors.forename: Metin
authors.initials: M
authors.lastname: Kaba
authors.forename: Halil
authors.initials: H
authors.lastname: Kara
authors.forename: Cuma
authors.initials: C
authors.lastname: Tasin
authors.forename: Selcuk
authors.initials: S
authors.lastname: Erkilinc
authors.forename: Gulcin
authors.initials: G
authors.lastname: Yildirim
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D004926:Escherichia coli / Q000302:isolation & purification; D005260:Female; D006801:Humans; D007709:Klebsiella / Q000302:isolation & purification; D008826:Microbial Sensitivity Tests; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis* / Q000188:drug therapy* / Q000382:microbiology; D011264:Pregnancy Trimesters; D011295:Prenatal Care / Q000379:methods*; D012189:Retrospective Studies; D014552:Urinary Tract Infections / Q000175:diagnosis* / Q000188:drug therapy*; D014556:Urine / Q000382:microbiology; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents