Bacterial profile and drug susceptibility pattern of urinary tract infection in pregnant women with ureteral stones and hydronephrosis

The aim of this study is to identify bacterial agents and their antibiotic susceptibility patterns isolated from pregnant women with symptomatic ureterolithiasis. Seventeen patients who had proven ureteral stones, positive urine cultures and underwent intervention for ureterolithiasis treatment between January, 2008 to December, 2011 were included in this study. Bacteriuria was defined as accounts of 10(5) cfu/ml in urine culture. The mean age and gestational period was 24.5 years and 25.5 weeks. The major symptoms were renal colic, hematuria and fever-chills. The overall prevalence of urinary tract infection (UTI) in pregnancy with ureteral stones was 17/65 (26.2%). Escherichia coli are the most common etiological agent (64.7%), followed by Klebsiella and Staphylococcus. The rate of resistance of E. coli to amoxicillin-clavulanate, ampicilin, cefotaxime, ciprofloxacin, trimethoprim/sulfamethoxazol, ceftriaxone, piperacillin/ tazobactam and imipenem were 50, 45.5, 100, 18, 36.4, 28.6, 36.4, 0%, respectively. The rate of resistance of Klebsiella to Ampicilin were 80% and Amoxicillin-Clavulanate, Cefazolin, Cefepime, Ceftazidim were 60%. There were no resistance of Klebsiella to ciprofloxacin, gentamicin, meropenem and amikacin. Significant bacteriuria was observed in these patients and we recommend urine cultures in all pregnant women with ureteral stones during pregnancy. Ceftriaxone is recommended for the patients who have UTI with ureteral stones during pregnancy because of its high specificity and sensitivity.