Pyelonephritis Caused by Multidrug-Resistant Bacteria During Pregnancy: A Case-Control Study

Area of Science:

• Obstetrics and Gynecology
• Infectious Diseases
• Medical Microbiology

Background:

• Pyelonephritis in pregnancy poses significant maternal-fetal risks, exacerbated by rising multidrug-resistant (MDR) bacterial infections.
• Characterizing MDR pathogens and their resistance patterns is crucial for managing pregnancy-related infections.

Purpose of the Study:

• To analyze the microbiological profiles and antimicrobial resistance of MDR pathogens causing pyelonephritis in pregnant women.
• To identify patient characteristics, risk factors, and pregnancy outcomes associated with MDR pyelonephritis.

Main Methods:

• A retrospective comparative study involving 171 pregnant patients hospitalized with acute pyelonephritis.
• Comparison of 34 patients with MDR infections against 137 patients with Non-MDR infections.

Main Results:

• MDR pyelonephritis patients were older, more frequently diagnosed in the third trimester, and more often multiparous.
• Prior antibiotic exposure and urological procedures were significant predictors of MDR infections (OR 20.37 and 13.23, respectively).
• MDR isolates showed higher resistance rates, and MDR pyelonephritis was associated with increased adverse neonatal outcomes, including NICU admission (OR 8.17).

Conclusions:

• Findings underscore the need for revising empirical antibiotic protocols and employing risk-adapted strategies for pregnant patients.
• Updated therapeutic approaches are essential to mitigate maternal and fetal morbidity associated with MDR pyelonephritis.