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Intrarenal Injection of Escherichia coli in a Rat Model of Pyelonephritis
Published on: July 18, 2017
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Urinary Tract Infection and Progression to Pyelonephritis: Group B Streptococcus versus E. coli.
Sarika Sachdeva1, Heather A Rosett2, Madison K Krischak3
1Department of Pediatrics, Johns Hopkins University, Baltimore, Maryland.
AJP Reports
|February 19, 2024
Summary
Pregnant women with lower urinary tract infections (LUTIs) caused by Escherichia coli are significantly more likely to develop pyelonephritis than those with Group B Streptococcus (GBS) LUTIs. However, both infections result in similar obstetric outcomes.
Area of Science:
- Obstetrics and Gynecology
- Infectious Diseases
- Urology
Background:
- Group B Streptococcus (GBS) and Escherichia coli lower urinary tract infections (LUTIs) in pregnancy can lead to severe complications like pyelonephritis.
- Understanding the comparative progression rates and associated morbidities of GBS versus E. coli LUTIs is crucial for clinical management.
Purpose of the Study:
- To compare the rates of progression to pyelonephritis between pregnant women with GBS and E. coli LUTIs.
- To compare infectious and obstetric morbidity secondary to GBS and E. coli LUTIs during pregnancy.
Main Methods:
- Retrospective cohort study of pregnant women diagnosed with GBS or E. coli LUTIs between July 2013 and May 2019.
- Data abstracted included demographics, infection details, and antepartum/intrapartum outcomes.
- Primary outcome was progression to pyelonephritis; secondary outcomes included related morbidities and obstetric complications. Logistic regression was used for adjusted analysis.
Main Results:
- E. coli LUTIs progressed to pyelonephritis in 15.6% of cases, compared to only 1.1% for GBS LUTIs (p < 0.001).
- Women with E. coli LUTIs were more likely to be younger, use tobacco, and have a history of acute cystitis or preterm birth.
- Adjusted analysis showed significantly lower odds of pyelonephritis progression in women with GBS LUTI compared to E. coli LUTI (aOR: 0.04).
Conclusions:
- E. coli is a significantly greater risk factor for progression to pyelonephritis from a lower urinary tract infection in pregnancy compared to GBS.
- Despite differing pyelonephritis rates, infectious and obstetric morbidities, including gestational age at delivery, preterm birth, and low birth weight, were similar between the two pathogens.
