Asymptomatic bacteriuria in young pregnant women in modern society

Cover Page

Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription Access

Abstract

The article provides an overview of the literature and existing international and national Guidelines on the etiology and main pathogens’ characteristics of asymptomatic bacteriuria, diagnostic criteria, management of young pregnant women with asymptomatic bacteriuria and antibacterial therapy regimens. Young pregnant women are a significant part of the society structure that requires protection. Young women in the age category of 15–17 years are identified as a group with a high risk of complications during pregnancy, delivery and the postpartum period, as well as perinatal pathologies. Women of this age group are characterized by a high risk of complications: the threatened miscarriage, premature birth as well as young pregnancies usually accompanied by sexually transmitted infections. It is important for this group of patients to be more carefully monitored by doctors in the hospitals, maternity welfare centers, during delivery and postpartum period. The main causative agents of asymptomatic bacteriuria in pregnant women are representatives of the Enterobacteriaceae family (88.0%). E. coli, Klebsiella spp., Staphilococcus spp. cause asymptomatic bacteriuria only in 3–10% of cases. The diagnosis is based on the Russian Clinical Guidelines for Urology and the Federal Clinical Guidelines 2020, as well as on the European Guidelines of the Urologists Association 2020. The National Guidelines indicate the main principles of asymptomatic bacteriuria treatment in high risk patients (pregnant and young). Despite the progress made in the urinary tract infections study, especially asymptomatic bacteriuria in pregnant women, and the development of practical Guidelines for the management of these patients, this issue remains important in modern society.

About the authors

Dinara G. Sitdikova

Bashkir State Medical University

Author for correspondence.
Email: edi4ka1@mail.ru
ORCID iD: 0000-0001-8425-6553

MD, PhD stud., Depart. of Obstetrics and Gynecology with the IDPO course

Russian Federation, Ufa, Russia

Irina B Fatkullina

Bashkir State Medical University

Email: Fib1971@mail.ru
ORCID iD: 0000-0001-5723-2062

MD, Prof., Head of the Medical Service

Russian Federation, Ufa, Russia

Anna Yu Lazareva

Bashkir State Medical University

Email: lazarevaayu@mail.ru
ORCID iD: 0000-0002-8299-0268

MD, PhD stud., Depart. of Obstetrics and Gynecology with the IDPO course

Russian Federation, Ufa, Russia

Yulia N Fatkullina

Bashkir State Medical University

Email: fatjul@mail.ru
ORCID iD: 0000-0003-0958-7891

MD, PhD stud., Depart. of Obstetrics and Gynecology with the IDPO course

Russian Federation, Ufa, Russia

Liana A Galiullina

I.I. Mechnikov Northwestern State Medical University

Email: galiullinamil@rambler.ru
ORCID iD: 0000-0002-3154-9157
Russian Federation, Saint-Petersburg, Russia

Liliana A Fayzullina

Bashkir State Medical University

Email: Liliana.92@inbox.ru

MD, PhD stud., Depart. of Obstetrics and Gynecology with the IDPO course

Russian Federation, Ufa, Russia

Svetlana A Galeeva

Bashkir State Medical University

Email: Svetagaleeva04@gmail.com
ORCID iD: 0000-0002-6911-3367

MD, PhD stud., Depart. of Obstetrics and Gynecology with the IDPO course

Russian Federation, Ufa, Russia

References

  1. Ivanova ON. Features of the immune and cytokine status in children with infections of urinoexcretory system. Medicus. 2015;(1):41–42. (In Russ.)
  2. Volgina GV, Frolova NF. Asymptomatic bacteriuria in pregnancy: evolution of generally accepted views. Terapiya. 2020;(1):104–111 (In Russ.) doi: 10.18565/therapy.2020.1.104-111.
  3. Zakharova IN, Osmanov IM, Machneva EB, Mumladze EB, Kasyanova AN, Aisanova MR. From bacteriuria to the urinary tract microbiome: the evolution of the views of researchers and clinicians. Meditsinkiy sovet. 2018;(17):168–176. (In Russ.) doi: 10.21518/2079-701X-2018-17-168-176.
  4. Savluk PA, Rya­zantsev EV, Baityakov AE, Ryazantsev VE. Etiology of community-acquired urinary infection in children and adolescents in the age aspect. XX Scientific and Practical Conference of Young scientists, postgraduates and students of the NP Ogarev National Research Mordovian State University. 2016;197–202. (In Russ.)
  5. Iremashvili VV. Urinary tract infections: a modern view of the problem. Russkiy meditsinskiy zhurnal. 2007;(29):2231. (In Russ.)
  6. Schappert SM. Am bulatory care visits to physician offices, hospital outpatient departments, and emergency departments: United States, 1997. Vital Health Stat 13. 1999;143:i–iv,1–39. PMID: 10633576.
  7. Beloglazova IP, Troshina AA, Poteshkina NG. Urinary tract infections: part 1. Lechebnoe delo. 2018;(1):18–24 (In Russ.) doi: 10.24411/2071-5315-2018-11978.
  8. Rafalsky VV, Chilova RA, Ishchenko AI. Urinary tract infections in pregnant women: antibiotic resistance, analysis of the practice of choosing antibacterial therapy in Russia. Effective pharmacotherapy in obstetrics and gynecology. 2006;(6):20–24. (In Russ.)
  9. Car J. Urinary tract infections in women: diagnosis and management in primary care. BMJ. 2006;332:94–97. doi: 10.1136/bmj.332.7533.94.
  10. Babkin PA, Petrov SB. Bacterial uncomplica­ted urinary tract infections. Medi.ru. 2009;3–5. https://medi.ru/info/7175/ (access date: 14.02.2021). (In Russ.)
  11. Nicolle L, Bradley S, Colgan R. Infectious Diseases Society of America guidelines for the diagnosis and treatment of asymptomatic bacteriuria in adults. Clin Infect Dis. 2005;40:643–654. doi: 10.1086/427507.
  12. Kuprienko NB, Smirnova NN. Urinary tract infection in adolescents. Modern approaches to diagnostics, treatment and dispensary observation. Nephrology (Saint-Petersburg). 2018;22(4):108–115. (In Russ.) doi: 10.24884/1561-6274-2018-22-4-108-115.
  13. World Health Organization. Teenage pregnancy. 2020. https://www.who.int/ru/news-room/fact-sheets/detail/adolescent-pregnancy (access date: 14.02.2021). (In Russ.)
  14. Zakharova IN, Osmanov IM, Mumladze EB, Machneva EB, Svintsitskaya VI, Kasyanova AV, Oblogina IS, Tambieva EV, Bekmurzaeva GB, Vasilieva TM, Lupan IN. Genetic and molecular basis of asymptomatic bacteriuria in children: what' snew? Meditsinskiy sovet. 2018;(2):182–187. (In Russ.) doi: 10.21518/2079-701X-2018-2-182-187.
  15. Perez-Moreno MO, Pico-Plana E, Grande-Armas J. Group B streptococcal bacteriuria during pregnancy as a risk factor for maternal intrapartum colonization: a prospective cohort study. Med Microbiol. 2017;66(4):454–460. doi: 10.1099/jmm.0.000465.
  16. Kuz­netsova YV, Orlova IS, Ujmajuridze MS, Drozdova NV. Young mother hood: gestational complication sandperinatal out comes. Universitetskaya meditsina Urala. 2019;(4):17–19. (In Russ.)
  17. Solieva NK. Features of pregnancy and childbirth management in young first-time mothers. Tibbietda yangi. 2016;(2):66–68. (In Russ.)
  18. Gupta K, Hooton T, Naber K. International clinical practice guidelines for the treatment of acute uncomplica­ted cystitis and pyelonephritis in women: A 2010 update by the Infectious Diseases Society of America and the European Society for Microbiology and Infectious Diseases. Clin Infect Dis. 2011;52(5):103–120. doi: 10.1093/cid/ciq257.
  19. Nys S, van Merode T, Bartelds A. Urinary tract infections in general practice patients: diagnostic tests versus bacteriological culture. J Antimicrob Chemother. 2006;57(5):955–958. doi: 10.1093/jac/dkl082.
  20. Palagin IS, Sukhorukova AV, Dekhnich AV, Edelshtein AV, Shevelev AN, Grinyov AV, Perepenova TS, Kozlov RS, Kogan MI. Current state of antibiotic resistance of pathogens causing community-acquired urinary tract infections in Russia: “DARMIS” Study (2010–2011). Klini­cheskaya mikrobiologiya i antimikrobnaya khimioterapiya. 2012;14(4):280–302. (In Russ.)
  21. Andersson P, Engberg I, Lidin-Janson G, Lincoln K, Hull R, Hull S, Svanborg C. Persistence of Escherichia coli bacteriuria is not determined by bacterial adherence. Infect Immun. 1991;59(9):2915–2921. doi: 10.1128/iai.59.9.2915-2921.1991.
  22. Gadzhieva ZK, Gomberg MA, Grigoryan VA, Gazimiev MA, Koz­lov YB. Specific features of diagnosis and treatment in pregnant women with uncomplicated urinary tract infection and urogenital infections. Akusherstvo i ginekologiya. 2018;(11):146–151. (In Russ.) doi: 10.18565/aig.2018.11.146-151.
  23. Alyaev YG, Glybochko PV, Pushkar DY. Urology. Russian clinical guidelines. M.: GEOTAR-Media; 2017. 544 р. (In Russ.)
  24. Perepanova TS The 2015 Federal Clinical Guidelines for Antimicrobial Therapy and Prevention of Infections of the Kidney, Urinary Tract, and Male Genitals. Terapevti­cheskiy arkhiv. 2016;88(4):100–104. (In Russ.) doi: 10.17116/terarkh2016884100-104.
  25. Bonkat G, Pickard R, Bartoletti R, Cai T, Bruyere F, Geerlings SE, Koves B, Wagenlehner F, Pilatz A, Pra­dere B, Veeratterapillay R., European Association of Uro­logy. EAU Guidelines urological infections. Update 2019. https://uroweb.org/wp-content/uploads/EAU-Guidelines-on-Urological-infections-2019.pdf (access date: 28.02.2021).
  26. Lerma EV. Asymptomatic bacteriuria. MED scape. 2021. https://emedicine.medscape.com/article/2059290-overview (access date: 28.02.2021).
  27. Gordovskaya NB, Korotchaeva YV. Asymptomatic bacteriuria in pregnant women: diagnosis and treatment. Almanac of clinical medicine. 2014;(30):57–60. (In Russ.)
  28. Ermolenko VM, Filatova NN, Malkoch AV. Urinary tract infection and its treatment in the age aspect. Lechashchiy vrach. 2012;(8):8. (In Russ.)
  29. Pustotina OA. ­Asymptomatic bacteriuria in pregnancy: what evidence-based medicine says. Meditsinskiy sovet. 2016;(4):123–129. (In Russ.) doi: 10.21518/2079-701X-2016-4-123-129.
  30. Hilt EE, McKinley K, Pearce MM, Rosenfeld AB, Zilliox MJ, Mueller ER, Brubaker L, Gai X, Wolfe AJ, Schreckenberger PC. Urine is not sterile: use of enhanced urine culture techniques to detect resident bacterial flora in the adult female bladder. J Clin Microbiol. 2014;52(3):871–876. doi: 10.1128/JCM.02876-13.
  31. Finucane TE. Urinary tract infection — requeiem for heavyweight. J Am Geriatr Soc. 2017;65(8):1650–1655. doi: 10.1111/jgs.14907.
  32. Chief State Sanitary Doctor of the Russian Federation — First Deputy Minister of Health of the Russian Federation Onishchenko GG. MUC 4.2.1890-04; 2004. 91 р. (In Russ.)
  33. Nikiforovsky NK, Stepankova EA, Suhorukova AO. Urinary tract infections in pregnancy (review). Siberian scientific medical journal. 2020;40(5):18–23. (In Russ.) doi: 10.15372/SSMJ20200502.
  34. Poselyugina OV. Uncomplicated urinary tract infection In pregnant women. Modern ideas about treatment and prevention. Lechashchiy vrach. 2018;(9):14. (In Russ.)
  35. Price TK, Mehrtash A, Kalesinskas L, Malki K, Hilt EE, Putonti C, Wolfe AJ. Genome sequences and annotation of two urinary isolates of E. coli. Stand Genomic Sci. 2016;11:79. doi: 10.1186/s40793-016-0202-6.
  36. Zdziarski J, Svanborg C, Wullt B, Hacker J, Dobrindt U. Molecular basis of commensalism in the urinary tract: low virulence or virulence attenuation? Infect Immun. 2008;76(2):695–703. doi: 10.1128/IAI.01215-07.
  37. Nicolle LE, Gupta K, Bradley SF, Colgan R, DeMuri GP, Drekonja D, Eckert LO, Geerlings SE, Koves B, Hooton TM, Juthani-Mehta M, Knight SL, Saint S, Schaeffer AJ, Trautner B, Wullt B, Siemieniuk R. Clinical practice guideline for the management of asymptomatic bacteriuria: 2019 Update by the Infectious Diseases Society of America. Clin Infect Dis. 2019;68(10):e83–e110. doi: 10.1093/cid/ciy1121.
  38. Order of the Ministry of Health of the Russian Federation No. 1130n dated October 20, 2020 “The procedure for providing medical care in the profile “obstetrics and gynecology”. Registered with the Ministry of Justice of the Russian Federation on November 12, 2020 No. 60869. (In Russ.)
  39. Smaill F, Vazquez JC. Antibiotics for asymptoma­tic bacteriuria in pregnancy. Cochrane Database Syst Rev. 2015;7:CD000490. doi: 10.1002/14651858.CD000490.pub3.
  40. Nikolskaia IG, Budykina TS, Bocharova II, Novikova SV, Efanov AA, Shirman LI, Krupskaia MS. Bacteriuria in pregnant women with chro­nic kidney disease and complications in the perinatal period. Rossiyskiy vestnik akushera-ginekologa. 2014;14(1):44–50. (In Russ.)
  41. Ayoyi AO, Kikuvi G, Bii C, Kariuki S. Prevalence, aetiology and antibiotic sensitivity profile of asympto­matic bacteriuria isolates from pregnant women in selec­ted antenatal clinic from Nairobi, Kenya. Pan Afr Med J. 2017;26:41. doi: 10.11604/pamj.2017.26.41.10975.
  42. Ilina IYu. Therapy of asymptomatic bacteriuria in pregnant women as prevention of gestational pyelonephritis. Russkiy meditsinskiy zhurnal. Mat’ i ditya. 2019;2(1):5–9. (In Russ.) doi: 10.32364/2618-8430-2019-2-1-5-9.
  43. Glaser AP, Schaeffer AJ. Urinary tract infection and bacteriuria in pregnancy. Urol Clin North Am. 2015;42(4):547–560. doi: 10.1016/j.ucl.2015.05.004.
  44. Satybaldin DA, Kravchenko EN, Votrina IR. Assimptomatic bacteriuria of pregnancy, diagnostics and experience of treatment in the health center in Omsk. Mat' i ditya v Kuzbasse. 2018;(1):11–13. (In Russ.)
  45. Shkodkin SV, Fliginskikh NA, Zhdanovskaya NV, Li LF, Yustitskaya EYu, Esina MM, Fedorenko SV. Primary results of a prospective comparative non-interventional study for the treatment of asymptomatic bacteriuria in pregnant women. Eksperimentalnaya i klinicheskaya urologiya. 2021;(1):124–130. (In Russ.) doi: 10.29188/­2222-8543-2021-14-1-124-128.
  46. Nicolle LE. The paradigm shift to non-treatment of asymptomatic bacteriuria. Pathogens. 2016;5(2):E38–E44. doi: 10.3390/pathogens5020038.
  47. Moore А, Doull М, Grad R, Groulx S, Pottie K, ­Tonelli M, Courage S, Garcia AJ, Thombs BD. Recommendations on screening for asymptomatic bacteriuria in pregnancy. For the Canadian Task Force on Preventive Health Care. CMAJ. 2018;190(27):E823–E830. doi: 10.1503/cmaj.171325.
  48. Perepanova TS, Kozlov RS, Rudnov VA, Sinyakova LA. Microbiological structure of urogenital infection and nosocomial infectious complications. Antimicrobial therapy and prevention of infections of the kidneys, urinary tract and male genitalia. Federal Clini­cal Guidelines. Moscow; 2017. p. 21–27. (In Russ.)

Supplementary files

Supplementary Files
Action
1. JATS XML

© 2022 Eco-Vector





This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies