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L Rojas Pérez
L Rojas Pérez
Facultad de Salud Pública, Carrera de Medicina, Escuela Superior Politécnica de Chimborazo, Panamericana Sur Km 1.5, código postal 060106, Riobamba, Ecuador
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B Cruz Basantes
B Cruz Basantes
Facultad de Salud Pública, Carrera de Medicina, Escuela Superior Politécnica de Chimborazo, Panamericana Sur Km 1.5, código postal 060106, Riobamba, Ecuador
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L Rojas Cruz
L Rojas Cruz
Facultad de Ciencias de la Salud, Carrera de Medicina, Universidad Nacional de Chimborazo, Avenida Antonio José de Sucre Km 1 1/2 vía a Guano, código postal 060103, Riobamba-Ecuador
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A Rojas Cruz
A Rojas Cruz
Facultad de Salud Pública, Carrera de Promoción para la Salud, Escuela Superior Politécnica de Chimborazo, Panamericana Sur Km 1.5, código postal 060106, Riobamba, Ecuador
Published Date
- Nov 9, 2023
Management of Urinary Tract Infection in Pregnancy
Abstract
Urinary tract infection is a frequent occurrence in pregnancy that can increase the risk of complications; therefore, it is essential to investigate it at the first prenatal consultation. It is classified as asymptomatic bacteriuria, cystitis, and pyelonephritis. This research aims to determine the most appropriate treatment for urinary tract infections during pregnancy according to the best available evidence. The methodology implemented a clinical question: What is the best treatment for urinary tract infections during pregnancy? The PICO format helped search for scientific information, such as the pregnant women’s population with urinary tract infections, whether the intervention received was an antibiotic treatment, was the comparison a no antibiotic treatment, and the result of preventing complications during pregnancy. The databases consulted were PubMed, Cochrane Library, the ACCESSSS search engine, Epistemonikos, DynaMed, and UpToDate. As a result of the information search process, 305 articles were obtained, of which 255 were discarded for not being within the inclusion criteria and 51 were used in this investigation. Of these 50 articles, 15 were eliminated because they were duplicates and 37 were used in this review. In conclusion, urinary tract infection causes increased perinatal maternal morbidity and mortality; therefore, it is essential to investigate and treat it.
Keywords: urinary tract infections, pregnancy, drug therapy.
Resumen
La infección del trato urinario es una afectación frecuente en el embarazo que puede aumentar el riego de complicaciones, por lo tanto, es fundamental investigarla desde la primera consulta prenatal, se clasifica en bacteriuria asintomática, cistitis y pielonefritis. El objetivo de esta investigación es determinar el tratamiento más adecuado para los cuadros de infección del tracto urinario durante el embarazo de acuerdo a la mejor evidencia disponible. En la metodología se implementó como pregunta clínica ¿cuál es el mejor tratamiento para la infección del tracto urinario durante el embarazo? bajo el formato PICO que ayudó en la búsqueda de información científica, la población son las mujeres gestantes con infección del tracto urinario, la intervención es el tratamiento antibiótico recibido, la comparación fue el no tratamiento antibiótico y el resultado la prevención de complicaciones durante el embarazo. Las bases de datos consultadas fueron PubMed, Cochrane Library, el buscador ACCESSSS, Epistemonikos, DynaMed y UpToDate. En el resultado del proceso de búsqueda de la información se obtuvo 305 artículos de los cuales se descartaron 255 por no estar dentro de los criterios de inclusión y se utilizaron 51 artículos que se servirán en esta investigación; de estos 50 se eliminan 15 artículos por estar duplicados y finalmente 37 artículos se utilizarán para la elaboración de esta revisión. Como principales conclusiones tenemos que la infección del tracto urinario causa aumento de la morbimortalidad materno perinatal, por lo tanto, es fundamental investigarla y tratarla.
Palabras Clave: infecciones urinarias, embarazo, quimioterapia.
References
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[19] Seifi M, Abbasalizadeh S, Mohammad-Alizadeh-Charandabi S, Khodaie L, Mirghafourvand M. The effect of Rosa [L. Rosa canina] on the incidence of urinary tract infection in the puerperium: A randomized placebo-controlled trial. Phyther Res Internet]. 2018 [cited 2022 Aug 18];32[1]:76–83. Available from: https://onlinelibrary.wiley.com/doi/10.1002/ptr.5950
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[26] Zaragoza-Marti A, Ruiz-Rodenas N, Herranz-Chofre I, Sanchez-SanSegundo M, Serrano Delgado VC, Hurtado-Sanchez JA. Serrano Delgado V de la C, Hurtado-Sanchez JA. Adherence to the mediterranean diet in pregnancy and its benefits on maternal-fetal health: a systematic review of the literature [Internet]. Frontiers in Nutrition. 2022 Mar;9:813942. [cited 2022 Aug 28] Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9009208/
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[2] Urinary Tract Infection [UTI] in Pregnancy [Internet]. DynaMed-EBSCO. 2022 [cited 2022 Aug 7]. Available from: https://www.dynamed.com/condition/urinary-tractinfection- uti-in-pregnancy
[3] Belete MA, Saravanan M. A systematic review on drug resistant urinary tract infection among pregnant women in developing countries in Africa and Asia; 2005-2016 [Internet]. Infect Drug Resist. 2020May;13:1465–1477. [cited 2022 Aug 28] Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7245001/
[4] Smaill FM, Vazquez JC. Antibiotics for asymptomatic bacteriuria in pregnancy [Internet]. Cochrane Database of Systematic Reviews. 2019 Nov;2019(11):CD000490. [cited 2022 Aug 18] Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6953361/ https://doi.org/10.1002/14651858.CD000490.pub4.
[5] Caron F, Galperine T, Flateau C, Azria R, Bonacorsi S, Bruyere F, et al. Practice guidelines for the management of adult communityacquired urinary tract infections [Internet]. Medecine et Maladies Infectieuses.. 2018 Aug;48(5):327–58. [cited 2022 Aug 18] Available from: https://www.sciencedirect.com/science/article/pii/S0399077X17310363?via%3Dihub
[6] Owens DK, Davidson KW, Krist AH, Barry MJ, Cabana M, Caughey AB, et al.; US Preventive Services Task Force. Screening for asymptomatic bacteriuria in adults: us preventive services task force recommendation statement [Internet]. JAMA. 2019 Sep;322(12):1188–94. [cited 2022 Aug 29] Available from: https://jamanetwork.com/journals/jama/fullarticle/2751726
[7] Schulz GS, Schutz F, Spielmann FV, da Ros LU, de Almeida JS, Ramos JG. Single-dose antibiotic therapy for urinary infections during pregnancy: A systematic review and meta-analysis of randomized clinical trials. International Journal of Gynecology & Obstetrics [Internet]. 2022 [cited 2022 Aug 28]; Available from: https://pubmed.ncbi.nlm.nih.gov/34995367/ https://doi.org/10.1002/ijgo.14087.
[8] Mansouri F, Sheibani H, Javedani Masroor M, Afsharian M. Extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae and urinary tract infections in pregnant/postpartum women: A systematic review and meta-analysis [Internet]. International Journal of Clinical Practice. . 2019 Sep;73(12):e13422. [cited 2022 Aug 28] Available from: https://pubmed.ncbi.nlm.nih.gov/31532050/
[9] Kranz J, Schmidt S, Lebert C, Schneidewind L, Mandraka F, Kunze M, et al. The 2017 update of the german clinical guideline on epidemiology, diagnostics, therapy, prevention, and management of uncomplicated urinary tract infections in adult patients. Part II: therapy and Prevention [Internet]. Urologia Internationalis. 2018;100(3):271–8. [cited 2022 Aug 18] Available from: https://pubmed.ncbi.nlm.nih.gov/29539622/
[10] Asymptomatic Bacteriuria [Internet]. DynaMed - EBSCO. 2022 [cited 2022 Aug 29]. Available from: https://www.dynamed.com/condition/asymptomatic-bacteriuria
[11] Wingert A, Pillay J, Sebastianski M, Gates M, Featherstone R, Shave K, et al. Asymptomatic bacteriuria in pregnancy: systematic reviews of screening and treatment effectiveness and patient preferences [Internet]. BMJ Open. 2019 Mar;9(3):e021347. [cited 2022 Aug 18] Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6429717/
[12] Koves B, Cai T, Veeratterapillay R, Pickard R, Seisen T, Lam TB, et al. Benefits and harms of treatment of asymptomatic bacteriuria: a systematic review and metaanalysis by the european association of urology urological infection guidelines panel [Internet]. European Urology.. 2017 Dec;72(6):865–8. [cited 2022 Aug 29] Available from: https://pubmed.ncbi.nlm.nih.gov/28754533/
[13] Lee AC, Mullany LC, Quaiyum M, Mitra DK, Labrique A, Christian P, et al. Effect of population-based antenatal screening and treatment of genitourinary tract infections on birth outcomes in Sylhet, Bangladesh [MIST]: a cluster-randomised clinical trial. The Lancet Global Health. [Internet]. 2019 Jan 1 [cited 2022 Aug 18];7[1]:e148–59. Available from: https://pubmed.ncbi.nlm.nih.gov/30554751/
[14] Getaneh T, Negesse A, Dessie G, Desta M, Tigabu A. Prevalence of urinary tract infection and its associated factors among pregnant women in ethiopia: a systematic review and meta-analysis. Biomed Res Int [Internet]. 2021 [cited 2022 Aug 28];2021. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8654570/ https://doi.org/10.1155/2021/6551526.
[15] Moore A, Doull M, Grad R, Groulx S, Pottie K, Tonelli M, et al.; Canadian Task Force on Preventive Health Care. Recommendations on screening for asymptomatic bacteriuria in pregnancy [Internet]. Canadian Medical Association journal. 2018 Jul;190(27):E823–30. [cited 2022 Aug 7] Available from: https://pubmed.ncbi.nlm.nih.gov/29986858/
[16] Henderson JT, Webber EM, Bean SI. Screening for asymptomatic bacteriuria in adults: updated evidence report and systematic review for the us preventive services task force. JAMA The Journal of the American Medical Association. [Internet]. 2019 Sep 24 [cited 2022 Aug 18];322[12]:1195–205.Available from: https://jamanetwork.com/journals/jama/fullarticle/2751725
[17] Ghouri F, Hollywood A, Ryan K. A systematic review of non-antibiotic measures for the prevention of urinary tract infections in pregnancy [Internet]. BMC Pregnancy and Childbirth. 2018;18(1):99. [cited 2022 Aug 18]Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5899369/
[18] Hooton T, Gupta K. Acute simple cystitis in women [Internet]. UpToDate. 2021 [cited 2022 Aug 7].Available from: https://www.uptodate.com/contents/ acute-simple-cystitis-in-women/print?search=cistitisaguda&source=search_ result&selectedTitle=1$\sim$150&usage_type=default&display_rank=1
[19] Seifi M, Abbasalizadeh S, Mohammad-Alizadeh-Charandabi S, Khodaie L, Mirghafourvand M. The effect of Rosa [L. Rosa canina] on the incidence of urinary tract infection in the puerperium: A randomized placebo-controlled trial. Phyther Res Internet]. 2018 [cited 2022 Aug 18];32[1]:76–83. Available from: https://onlinelibrary.wiley.com/doi/10.1002/ptr.5950
[20] Urine culture [Internet]. DynaMed-EBSCO. 2022 [cited 2022 Aug 29]. Available from: https://www.dynamed.com/lab-monograph/urine-culture
[21] Complicated Urinary Tract Infection [UTI,Internet]. DynaMed-EBSCO. 2022 [cited 2022 Aug 7]. Available from: https://www.dynamed.com/condition/complicatedurinary- tract-infection-uti
[22] Meyrier. Alain. Sampling and evaluation of voided urine in the diagnosis of urinary tract infection in adults [Internet]. UpToDate. 2021 [cited 2022 Aug 7]. Available from: https://www.uptodate.com/contents/ sampling-and-evaluation-of-voided-urine-in-the-diagnosis-of-urinary-tract-infection-in-adults/ print?search=infeccióndeltractourinario&source=search_result&selectedTitle=11$\ sim$150&usage_type=default&display_rank=9
[23] Kranz J, Schmidt S, Lebert C, Schneidewind L, Mandraka F, Kunze M, et al. The 2017 update of the german clinical guideline on epidemiology, diagnostics, therapy, prevention, and management of uncomplicated urinary tract infections in adult patients: Part 1 [Internet]. Urologia Internationalis.. 2018;100(3):263–70. [cited 2022 Aug 18]Available from: https://pubmed.ncbi.nlm.nih.gov/29342469/
[24] Puopolo K, Madoff L. Group B streptococcal infection in pregnant individuals [Internet]. UpToDate. 2022 [cited 2022 Aug 29]. Available from: https://www. uptodate.com/contents/group-b-streptococcal-infection-in-pregnant-individuals/ print?search=%22UrinaryTractInfectioninPregnancy%22&source=search_ result&selectedTitle=4$\sim$150&usage_type=default&display_rank=2
[25] Thadhani R, Maynard S. Maternal adaptations to pregnancy: Renal and urinary tract physiology [Internet]. UpToDate.2022 [cited 2022 Aug 31]. Available from: https://www.uptodate.com/contents/maternal-adaptations-topregnancy- renal-and-urinary-tract-physiology/print?search=infección del tracto urinario&topicRef=8065&source=see_link
[26] Zaragoza-Marti A, Ruiz-Rodenas N, Herranz-Chofre I, Sanchez-SanSegundo M, Serrano Delgado VC, Hurtado-Sanchez JA. Serrano Delgado V de la C, Hurtado-Sanchez JA. Adherence to the mediterranean diet in pregnancy and its benefits on maternal-fetal health: a systematic review of the literature [Internet]. Frontiers in Nutrition. 2022 Mar;9:813942. [cited 2022 Aug 28] Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9009208/
[27] Melero V, García de la Torre N, Assaf-Balut C, Jimenez I, Del Valle L, Duran A, et al. Effect of a mediterranean diet-based nutritional intervention on the risk of developing gestational diabetes mellitus and other maternal-fetal adverse events in hispanic women residents in spain [Internet]. Nutrients. 2020 Nov;12(11):1–14. [cited 2022 Aug 18] Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7696021/
[28] Colditz G. Healthy diet in adults [Internet]. UpToDate. 2022 [cited 2022 Sep 1]. Available from: https://www.uptodate.com/contents/healthy-diet-inadults/ print?search=dieta
[29] Assaf-Balut C, Garcia de la Torre N, Duran A, Fuentes M, Bordiu E, Del Valle L, et al. A mediterranean diet with an enhanced consumption of extra virgin olive oil and pistachios improves pregnancy outcomes in women without gestational diabetes mellitus: a sub-analysis of the st. Carlos gestational diabetes mellitus prevention study [Internet]. Annals of Nutrition and Metabolism. 2019;74(1):69–79. [cited 2022 Aug 26] Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6425818/
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