Urinary Bacterial Profile and Antibiotic Susceptibility in Pregnant Adolescents and Pregnant Low Obstetric Risk Adult Women

Figures & data

Table 1 Association Between Pregnant Female’s Age and Occurrence of Bacteriuria

Characteristics	Bacteriuria
	Positive (%)	Negative (%)	Total (%)	OR^a (CI^b 95%)	p value
Adolescent
- No	258 (10.13)	2289 (89.87)	2547 (100)
- Yes	66 (17.01)	322 (82.99)	388 (100)	1.82 (1.35–2.44)	0.0001*^c

Notes: *p value, statistically significant. ^cPerson Chi-Square.

Abbreviations: ^aOR, odds ratio; ^bCI, confidence interval.

Table 2 Sociodemographic Characteristics and Obstetric History of Pregnant Adolescents and Adults Diagnosed with Bacteriuria^a

Characteristics	Adolescents	Adults
	Mean or n^b (±SD^c or %)	Média ou n^b (±SD^c or %)	p value
Age	15.29 ± 1.28	28.93± 6.06	<0.001*
Number of previous pregnancies	1.09± 0.34	2.25 ± 1.39	<0.001*
Number of previous deliveries	0.06± 0.30	0.95 ± 1.11	<0.001*
Number of previous abortions/miscarriages	0.03± 0.17	0.27 ± 0.674	<0.001*
Marital status			<0.001*^d
- married/ stable relationship/ single with partner	54 (81.82%)	142 (55%)
- single without a partner/ separated	12 (18.18%)	116 (45%)
Smoking
- yes	3 (4.6%)	17 (6.6%)	0.775^d
Gestational age at urine culture	23.30 ± 9.41	23.64 ± 9.28	0.752

Notes: ^aThe numbers do not always add up to the total due to absent values. ^dPerson Chi-Square. *p value, statistically significant.

Abbreviations: ^bn, number of individuals; ^cSD, standard deviation.

Table 3 Main Pathogens Involved in the Occurrence of Bacteriuria Among the Pregnant Adolescents and Adults

Bacteria	Number of Urine Cultures (%) - Adolescents	Number of Urine Cultures (%) - Adults
Escherichia coli	49 (49)	151 (42.18)
Streptococcus agalactiae	18 (18)	72 (20.11)
Klebsiella pneumoniae	7 (7)	13 (3.63)
Proteus mirabilis	5 (5)	15 (4.19)
Staphylococcus saprophyticus	5 (5)	16 (4.47)
Enterococcus faecalis	4 (4)	47 (13.13)
Coagulase-negative staphylococci	3 (3)	20 (5,0.9)
Enterobacter sp	3 (3)	7 (2)
Staphylococcus aureus	2 (2)	6 (1.68)
Acinetobacter calcoaceticus-baumannii complex	1 (1)	-
Citrobacter koseri	1 (1)	-
Morganella morganii	1 (1)	-
Streptococcus viridans	1 (1)	1 (0.28)
Serratia marcescens	-	7 (2.0)
Corynebacterium sp	-	1 (0.28)
Alcaligenes sp	-	1 (0.28)
Pseudomonas shigelloides	-	1 (0.28)

Table 4 Characteristics of the Urine Test of Adolescents and Adults When the Urine Culture Tested Positive^a

Characteristics of the Urine Test When the Urine Culture Tested Positive	Adolescents (n = 100)	Adults (n = 358)
	Mean or n^b (± SD^c or %)	Mean or n^b (± SD^c or %)	OR^d (CI^e 95%)	p value
ph	6.40 ± 0.79	6.29 ± 0.74		0.169
Density	1.017 ± 0.006	1.018 ± 0.006		0.478
Blood
- absent	35 (62.5%)	110 (55.8%)
- present	21 (37.5%)	87 (44.2%)	1.31 (0.72–2.43)	0.374^f
Proteíns
- absent	44 (78.6%)	173 (87.8%)
- present	12 (21.4%)	24 (12.2%)	0.51 (0.24–1.10)	0.084^g
Leukocytes	44.43± 40.45	22.74 ± 31.36		<0.001*
Erythrocytes	11.52 ± 25.27	6.40 ± 16.64		0.698
Casts
- absent	53 (94.6%)	182 (92.4%)
- present	3 (5.4%)	15 (7.6%)	1.46 (0.41–5.22)	0.564^g
Crystals
- absent	42 (75%)	140 (71.1%)	1
- phosphate crystals	10 (17.9%)	18 (9.1%)	0.54 (0.23–1.26)	0.15
- calcium oxalate crystals	3 (5.4%)	32 (16.2%)	3.20 (0.93–10.9)	0.064
- urate crystals	1 (1.8%)	7 (3.6%)	2.10 (0.25–17.6)	0.49
Other elements
- absent	10 (17.9%)	39 (19.8%)	1
- numerous bacteria	36 (64.3%)	107 (54.3%)	0.76 (0.35–1.68)	0.50
- rare bacteria	7 (12.5%)	41 (20.8%)	1.50 (0.52–4.34)	0.45
- fungi	3 (5.4%)	10 (5.1%)	0.85 (0.20–3.70)	0.83
Etiological agent				0.022*^h
- cocci or gram-positive bacilli^f	27 (27%)	110 (30.7%)
	67 (67%)	195 (54.5%)
- Enterobacteria/gram-negative bacteria
- Enterococcus sp	4 (4%)	47 (13.1%)
- Staphylococcus aureus	2 (2%)	6 (1.7%)

Notes: ^aThe numbers do not always add up to the total due to absent values. ^fExcept Staphylococcus aureus and Enterococcus sp. ^gPerson Chi-Square. ^hFisher`s Exact Test. *p value, statistically significant.

Abbreviations: ^bn, number of individuals; ^cSD, standard deviation; ^dOR, odds ratio; ^eCI, confidence interval.

Table 5 Microbial Resistance Profile of Gram-Negative Bacteria and Enterococcus Sp Isolated in the Urine of Pregnant Adolescents and Adults

Resistance in the Antibiogram	Enterobacter sp		Enterococcus faecalis		Escherichia coli		Klebsiella pneumoniae		Proteus mirabilis
	ADO^a	ADU^b	ADO^a	ADU^b	ADO^a	ADU^b	ADO^a	ADU^b	ADO^a	ADU^b
	n^c (%)	n^c (%)	n^c (%)	n^c (%)	n^c (%)	n^c (%)	n^c (%)	n^c (%)	n^c (%)	n^c (%)
Nalidixic acid	0 (0)	0 (0)	0 (0)	0 (0)	4 (8.2)	16 (10.6)	0 (0)	0 (0)	0 (0)	0 (0)
Ampicillin	3 (100)	7 (100)	0 (0)	0 (0)	22 (44.9)	64 (42.4)	7 (100)	13 (100)	1 (20)	7 (46.7)
Penicillin	0 (0)	0 (0)	0 (0)	0 (0)	0 (0)	0 (0)	0 (0)	0 (0)	0 (0)	0 (0)
AMC^d	2 (66.7)	5 (71.4)	0 (0)	0 (0)	9 (18.4)	19 (12.6)	0 (0)	0 (0)	0 (0)	0 (0)
Cephalothin	3 (100)	5 (71.4)	0 (0)	0 (0)	19 (38.8)	72 (47.7)	2 (28.6)	0 (0)	0 (0)	0 (0)
Cefoxitin	1 (33.3)	4 (57.1)	0 (0)	0 (0)	0 (0)	7 (4.6)	0 (0)	0 (0)	0 (0)	0 (0)
Cefuroxime	2 (66.7)	5 (71.4)	0 (0)	0 (0)	4 (8.2)	7 (4.6)	0 (0)	0 (0)	0 (0)	0 (0)
Cefotaxime	0 (0)	0 (0)	0 (0)	0 (0)	1 (2)	0 (0)	0 (0)	0 (0)	0 (0)	0 (0)
Ceftazidime	0 (0)	0 (0)	0 (0)	0 (0)	1 (2)	0 (0)	0 (0)	0 (0)	0 (0)	0 (0)
Ceftriaxone	0 (0)	0 (0)	0 (0)	0 (0)	1 (2)	3 (2)	0 (0)	0 (0)	0 (0)	0 (0)
Cefepime	0 (0)	0 (0)	0 (0)	0 (0)	2 (4.1)	3 (2.0)	0 (0)	0 (0)	0 (0)	0 (0)
Nitrofurantoin	0 (0)	5 (71.4)	0 (0)	0 (0)	3 (6.1)	11 (7.3)	6 (85.7)	6 (46.2)	3 (60)	10 (66.7)
SMZ/TMP^e	0 (0)	0 (0)	0 (0)	0 (0)	9 (18.4)	27 (17.9)	0 (0)	0 (0)	3 (60)	5 (33.3)
Norfloxacin	0 (0)	0 (0)	0 (0)	10 (21.3)	0 (0)	6 (4)	0 (0)	0 (0)	0 (0)	0 (0)
Ciprofloxacin	0 (0)	0 (0)	0 (0)	2 (4.3)	1 (2)	8 (5.3)	0 (0)	0 (0)	0 (0)	1 (6.7)
Levofloxacin	0 (0)	0 (0)	0 (0)	0 (0)	1 (2)	1 (0.7)	0 (0)	0 (0)	0 (0)	0 (0)
Gentamicin	2 (66.7)	1 (14.3)	1 (25)	6 (12.8)	2 (4.1)	8 (5.3)	0 (0)	0 (0)	0 (0)	0 (0)
Streptomycin	0 (0)	0 (0)	1 (25)	10 (21.3)	0 (0)	0 (0)	0 (0)	0 (0)	0 (0)	0 (0)
Multisensitivity	0 (0)	0 (0)	3 (75)	28 (59.6)	20 (40.8)	50 (33.1)	0 (0)	0 (0)	2 (40)	1 (6.7)
ESBL	0 (0)	0 (0)	0 (0)	0 (0)	2 (4.1)	3 (2)	0 (0)	0 (0)	0 (0)	0 (0)

Abbreviations: ^aADO, adolescents; ^bADU, adults; ^cn, number of individuals; ^dAMC, amoxicillin/clavulanate; ^eSMZ/TMP, sulfamethoxazole/trimethoprim.

Table 6 Microbial Resistance Profile of Gram-Positive and All Bacteria Isolated in the Urine of Pregnant Adolescents and Adults

Resistance in the Antibiogram	Staphylococcus aureus		Staphylococcus saprophyticus		Streptococcus agalactiae		All Bacterial Species Isolated in Urine
	ADO^a	ADU^b	ADO^a	ADU^b	ADO^a	ADU^b	ADO^a	ADU^b
	n^c (%)	n^c (%)	n^c (%)	n^c (%)	n^c (%)	n^c (%)	n^c (%)	n^c (%)	OR^d (CI^e 95%)	p value
Nalidixic acid	0 (0)	0 (0)	0 (0)	0 (0)	0 (0)	0 (0)	4 (4)	18 (5)	1.27 (0.42–3.84)	0.454
Ampicillin	0 (0)	0 (0)	0 (0)	0 (0)	0 (0)	0 (0)	35 (35)	98 (27.4)	0.70 (0.44–1.12)	0.143
Penicillin	2 (100)	5 (83.3)	0 (0)	0 (0)	0 (0)	0 (0)	2 (2)	5 (1.4)	0.69 (0.13–3.63)	0.474
AMC^f	0 (0)	0 (0)	0 (0)	0 (0)	0 (0)	0 (0)	11 (11)	30 (8.4)	0.74 (0.36–1.53)	0.428
Cephalothin	0 (0)	0 (0)	0 (0)	0 (0)	0 (0)	0 (0)	24 (24)	82 (22.9)	0.94 (0.56–1.58)	0.819
Cefuroxime	0 (0)	0 (0)	0 (0)	0 (0)	0 (0)	0 (0)	7 (7)	17 (4.7)	0.66 (0.27–1.64)	0.388
Cefotaxime	0 (0)	0 (0)	0 (0)	0 (0)	0 (0)	0 (0)	1 (1)	1 (0.3)	0.94 (0.41–2.13)	0.389
Ceftazidime	0 (0)	0 (0)	0 (0)	0 (0)	0 (0)	0 (0)	1 (1)	0 (0)	0.09 (0.004–2.29)	0.218
Ceftriaxone	0 (0)	0 (0)	0 (0)	0 (0)	0 (0)	0 (0)	2 (2)	3 (0.8)	0.41 (0.07–2.51)	0.300
Cefepime	0 (0)	0 (0)	0 (0)	0 (0)	0 (0)	0 (0)	2 (2)	3 (0.8)	0.37 (0.08–1.66)	0.180
Nitrofurantoin	0 (0)	0 (0)	0 (0)	0 (0)	0 (0)	0 (0)	12 (12)	34 (9.5)	0.41 (0.07–2.51)	0.470
SMZ/TMP^g	0 (0)	0 (0)	0 (0)	0 (0)	0 (0)	0 (0)	13 (13)	33 (9.2)	0.68 (0.34–1.35)	0.279
Norfloxacin	0 (0)	1 (16.7)	0 (0)	0 (0)	0 (0)	0 (0)	0 (0)	17 (4.7)	10.30 (0.6–172.8)	0.105
Ciprofloxacin	0 (0)	0 (0)	0 (0)	0 (0)	0 (0)	0 (0)	1 (1)	11 (3.1)	3.13 (0.40–24.60)	0.223
Levofloxacin	0 (0)	0 (0)	0 (0)	0 (0)	0 (0)	0 (0)	1 (1)	1 (0.3)	0.28 (0.017–4.47)	0.389
Gentamicin	0 (0)	0 (0)	0 (0)	0 (0)	0 (0)	0 (0)	5 (5)	15 (4.2)	1.24 (0.46–3.37)	0.451
Streptomycin	0 (0)	0 (0)	0 (0)	0 (0)	0 (0)	0 (0)	1 (1)	10 (2.8)	2.84 (0.36–22.49)	0.268
Multisensitivity	0 (0)	1 (16.7)	5 (100)	16 (100)	18 (100)	72 (100)	52 (52)	191 (53)	1.05 (0.68–1.65)	0.811
ESBL	0 (0)	0 (0)	0 (0)	0 (0)	0 (0)	0 (0)	2 (2)	3 (0.8)	0.41 (0.068–2.51)	0.300

Abbreviations: ^aADO, adolescents; ^bADU, adults; ^cn, number of individuals; ^dOR, odds ratio; ^eCI, confidence interval; ^fAMC, amoxicillin/clavulanate; ^gSMZ/TMP, sulfamethoxazole-trimethoprim.