Abstract

Urinary tract infections (UTIs) are a significant issue in women of all ages, but they are especially common during pregnancy. Co-infection of the Coronavirus Disease 2019 (COVID-19) with UTIs in pregnant females is a hot topic today, as it may be linked to various conditions. Furthermore, understanding the types of bacteria that cause UTIs and related antimicrobial resistance may aid the clinician in selecting the appropriate empirical treatment. This study aimed to isolate and characterize causative agents of UTIs and determine antimicrobial treatment sensitivity patterns among pregnant women diagnosed with the COVID-19 admitted to Teaching Hospital X in Iraq. Antimicrobial drug resistance testing was performed on 42 mid-stream urine samples that had been prepared for culture. Escherichia coli (18/42.85%), Klebsiella pneumoniae (9/21.45%), Streptococcus galactica (7/16.66%), and Proteus mirabilis (4/9.52%) were the bacteria isolated and diagnosed from pregnant women. The infections Pseudomonas aeruginosa and Staphylococcus aureus were the least common (2/4.7). In conclusion, the isolated uro-pathogens showed high resistance to Gentamicin, Cefuroxime, Ceftriaxone and sensitive to Ampicillin and Nitrofurantoin. The common cause of UTIs among pregnant women infected with the COVID-19 was discovered to be Escherichia coli. Before recommending therapy, culture and sensitivity testing of isolates from urine tests should be conducted on a regular basis.

References

1. World Health Organization. Novel coronavirus-China; 2020. 2. Isam JZ, Kamil KZ, Banoon Shaima R. Review about COVID-19. Research Journal of Biotechnology. 2021; 16 (4): 229-33. 3. Sahu KK, Lal A, Mishra AK. COVID-2019 and pregnancy: a plea for transparent reporting of all cases. Acta Obstet Gynecol Scand. 2020; 99 (7): 951. 4. Zhu N, Zhang D, Wang W, Li X, Yang B, Song J, et al. A novel coronavirus from patients with pneumonia in China. New Engl J. 2020; 382: 727–33. 5. Salma U. Relationship of COVID-19 with pregnancy. Taiwanese Journal of Obstetrics & Gynecology. 2021; 60 (3): 405–11. 6. Habak PJ, Griggs Jr RP. Urinary tract infection in pregnancy. In: Stat Pearls; 2021. 7. Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020; 395: 507–13. 8. Chen Y, Liu Q, Guo D. Coronaviruses: genome structure, replication, and pathogenesis. J Med Virol. 2020; 92: 418–23. 9. Mumm JN, Osterman A, Ruzicka M, Stihl C, Vilsmaier T, Munker D, et al. Urinary frequency as a possibly overlooked symptom in COVID19 patients: does SARS-CoV-2 cause viral cystitis?. European Urology. 2020; 78 (4): 624-8. 10. Fry CH, Vahabi B. The role of the mucosa in normal and abnormal bladder function. Basic & Clinical Pharmacology & Toxicology. 2016; 119 (Suppl 3): 57-62. 11. Cheung EW, Zachariah P, Gorelik M, Boneparth A, Kernie SG, Orange JS, et al. Multisystem inflammatory syndrome related to COVID-19 in previously healthy children and adolescents in New York City. JAMA; 2020. 12. Dunkelberg WE. Kirby-bauer disk diffusion method. American Journal of Clinical Pathology. 1981; 75: 273. 13. Breyer BN, van den Eeden SK, Horberg MA, Eisenberg ML, Deng DY, Smith JF. HIV status is an independent risk factor for reporting lower urinary tract symptoms. J Urol. 2011; 185 (5): 1710–5. 14. Dhar N, Dhar S, Timar R, Lucas S, Lamb LE, Chancellor MB. De novo urinary symptoms associated with COVID-19: COVID-19-associated cystitis. J Clin Med Res. 2020; 12 (10): 681-2. 15. Sighinolfi MC, Rocco B, Mussini C. COVID-19: importance of the awareness of the clinical syndrome by urologists. Eur Urol. 2020; 78 (1): e40–1. 16. Tran H, Chung DE. Incidence and management of de novo lower urinary tract symptoms after pelvic organ prolapse repair. Curr Urol Rep. 2017; 18: 87. 17. Abad ED, Khameneh A, Vahedi L. Identification phenotypic and genotypic characterization of biofilm formation in Escherichia coli isolated from urinary tract infections and their antibiotics resistance. BMC Res Notes. 2019; 12: 796. 18. Yun KW, Kim HY, Park HK, Kim W, Lim IS. Virulence factors of uropathogenic Escherichia coli of urinary tract infections and asymptomatic bacteriuria in children. J Microbiol Immunol Infect. 2014; 47 (6): 455–61. 19. Rowe TA, Juthani-Mehta M. Urinary tract infection in older adults. Aging Health. 2013; 9 (5): 519-28. 20. Lamb LE, Dhar N, Timar R, Wills M, Dhar S, Chancellor MB. COVID-19 inflammation results in urine cytokine elevation and causes COVID-19 associated cystitis (CAC). Medical Hypotheses. 2020; 145: 110375. 21. Rodhe N, Mölstad S, Englund L, Svärdsudd K. Asymptomatic bacteriuria in a population of elderly residents living in a community setting: prevalence, characteristics and associated factors. Family Practice. 2006; 23 (3): 303-7. 22. Malekzadegan Y, Khashei R, Sedigh Ebrahim-Saraie H, Jahanabadi Z. Distribution of virulence genes and their association with antimicrobial resistance among uropathogenic Escherichia coli isolates from Iranian patients. BMC Infectious Diseases. 2018; 18 (1): 1-9. 23. Lee JH, Subhadra B, Son YJ, Kim DH, Park HS, Kim JM, et al. Phylogenetic group distributions, virulence factors and antimicrobial resistance properties of uropathogenic Escherichia coli strains isolated from patients with urinary tract infections in South Korea. Letters in Applied Microbiology. 2016; 62 (1): 84-90. 24. SAS Institute Inc. SAS/STAT®9.2. Users Guide; 2008.

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