TY - JOUR
T1 - Diagnostic and treatment difficulties of pyelonephritis in pregnancy in resource-limited settings
AU - McGready, Rose
AU - Wuthiekanun, Vanaporn
AU - Ashley, Elizabeth A.
AU - Tan, Saw Oo
AU - Pimanpanarak, Mupawjay
AU - Viladpai-nguen, Samuel Jacher
AU - Jesadapanpong, Wilarat
AU - Blacksell, Stuart D.
AU - Proux, Stephane
AU - Day, Nicholas P.
AU - Singhasivanon, Pratap
AU - White, Nicholas J.
AU - Nosten, François
AU - Peacock, Sharon J.
PY - 2010/12
Y1 - 2010/12
N2 - Limited microbiology services impede adequate diagnosis and treatment of common infections such as pyelonephritis in resource-limited settings. Febrile pregnant women attending antenatal clinics at Shoklo Malaria Research Unit were offered urine dipstick, sediment microscopy, urine culture, and a 5-mL blood culture. The incidence of pyelonephritis was 11/1,000 deliveries (N = 53 in 4,819 pregnancies) between January 7,2004 and May 17,2006. Pyelonephritis accounted for 20.2% (41/203) of fever cases in pregnancy. Escherichia coli was the most commonly isolated pathogen: 87.5% (28/32) of organisms cultured. Susceptibility of E. coli to ampicillin (14%), cotrimoxazole (21%), and amoxicillin-clavulanic acid (48%) was very low. E. coli was susceptible to ceftriaxone and ciprofloxacin. The rate of extended spectrum β-lactamase (4.2%; 95% confidence interval = 0.7-19.5) was low. The rate and causes of pyelonephritis in pregnant refugee and migrant women were comparable with those described in developed countries. Diagnostic innovation in microbiology that permits affordable access is a high priority for resource-poor settings.
AB - Limited microbiology services impede adequate diagnosis and treatment of common infections such as pyelonephritis in resource-limited settings. Febrile pregnant women attending antenatal clinics at Shoklo Malaria Research Unit were offered urine dipstick, sediment microscopy, urine culture, and a 5-mL blood culture. The incidence of pyelonephritis was 11/1,000 deliveries (N = 53 in 4,819 pregnancies) between January 7,2004 and May 17,2006. Pyelonephritis accounted for 20.2% (41/203) of fever cases in pregnancy. Escherichia coli was the most commonly isolated pathogen: 87.5% (28/32) of organisms cultured. Susceptibility of E. coli to ampicillin (14%), cotrimoxazole (21%), and amoxicillin-clavulanic acid (48%) was very low. E. coli was susceptible to ceftriaxone and ciprofloxacin. The rate of extended spectrum β-lactamase (4.2%; 95% confidence interval = 0.7-19.5) was low. The rate and causes of pyelonephritis in pregnant refugee and migrant women were comparable with those described in developed countries. Diagnostic innovation in microbiology that permits affordable access is a high priority for resource-poor settings.
UR - http://www.scopus.com/inward/record.url?scp=79551631910&partnerID=8YFLogxK
U2 - 10.4269/ajtmh.2010.10-0332
DO - 10.4269/ajtmh.2010.10-0332
M3 - Article
C2 - 21118943
AN - SCOPUS:79551631910
SN - 0002-9637
VL - 83
SP - 1322
EP - 1329
JO - American Journal of Tropical Medicine and Hygiene
JF - American Journal of Tropical Medicine and Hygiene
IS - 6
ER -
