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Ampicillin-resistant Escherichia coli in gestational pyelonephritis: increased occurrence and association with the

A Hart1, B J Nowicki, B Reisner

  • 1Departments of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, Texas, USA.

Insights

Ampicillin resistance in Escherichia coli from pregnant women with pyelonephritis has increased significantly. This resistance is linked to virulence factors, particularly the dra gene cluster, posing potential risks during pregnancy.

Area of Science:

  • Medical Microbiology
  • Infectious Diseases
  • Obstetrics

Background:

  • Pyelonephritis during pregnancy is a significant concern.
  • Escherichia coli is a common cause of urinary tract infections, including pyelonephritis.
  • Antibiotic resistance in uropathogens poses a growing threat to maternal and neonatal health.

Purpose of the Study:

  • To evaluate ampicillin resistance patterns in Escherichia coli isolates from pregnant women with pyelonephritis.
  • To investigate the association between ampicillin resistance and specific virulence factors, including the dra gene cluster.
  • To compare current resistance rates with historical data.

Main Methods:

  • Analysis of 78 Escherichia coli isolates from pregnant women diagnosed with pyelonephritis.
  • Determination of ampicillin resistance prevalence.
  • Investigation of the presence and association of the dra gene cluster and O75 serotype with ampicillin resistance.

Main Results:

  • Ampicillin resistance in pyelonephritis-causing E. coli has risen to 46%, a significant increase from 22% in 1985.
  • Resistance rates varied by trimester: 60% in the first, 33% in the second, and 53% in the third.
  • 75% of dra(+) E. coli isolates were ampicillin resistant, and 87% of ampicillin-resistant strains belonged to the O75 serotype carrying the dra gene cluster.

Conclusions:

  • A significant increase in ampicillin resistance among E. coli causing gestational pyelonephritis has been observed.
  • The dra gene cluster, associated with virulence, is linked to ampicillin resistance in these isolates.
  • Further research is recommended for obstetric and neonatal wards due to potential risks, especially for neonates.

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