Archive for July 5, 2012

Urinary tract infections during pregnancy.

Am Fam Physician. 2000 Feb 1 V.61 N.3  P.713-21.

Delzell JE Jr, Lefevre ML.

Health Sciences Center, University of Missouri-Columbia School of Medicine, 65212, USA.

Erratum in

Am Fam Physician 2000 Jun 15;61(12):3567.


Urinary tract infections are common during pregnancy, and the most common causative organism is Escherichia coli. Asymptomatic bacteriuria can lead to the development of cystitis or pyelonephritis. All pregnant women should be screened for bacteriuria and subsequently treated with antibiotics such as nitrofurantoin, sulfisoxazole or cephalexin. Ampicillin should no longer be used in the treatment of asymptomatic bacteriuria because of high rates of resistance. Pyelonephritis can be a life-threatening illness, with increased risk of perinatal and neonatal morbidity. Recurrent infections are common during pregnancy and require prophylactic treatment. Pregnant women with urinary group B streptococcal infection should be treated and should receive intrapartum prophylactic therapy.




Comment: This review of UTIs in pregnancy emphasizes: 1) importance of treating asymptomatic infections; 2) need to screen; 3) treat with agents which are safe in pregnancy; 4)avoid ampicillin due to high rates of resistant organisms; and 5) Group B strep UTIs need intrapartum prophylaxis.

July 5, 2012 at 10:52 am

Virulence potential of Escherichia coli strains causing asymptomatic bacteriuria during pregnancy.

J Clin Microbiol. 2011 Nov  V.49 N. 11 P.3950-3.

Lavigne JP, Boutet-Dubois A, Laouini D, Combescure C, Bouziges N, Marès P, Sotto A.

INSERM, U1047, Université Montpellier 1, UFR de Médecine, 30908 Nîmes Cedex 2, France.


We compared the virulence properties of a collection of asymptomatic bacteriuria (ABU) Escherichia coli strains to urinary tract infection (UTI) strains isolated from pregnant women in a university hospital over 1 year. The in vitro and in vivo studies suggest that ABU strains presented a virulence behavior similar to that of strains isolated from cases of cystitis.


Comment: Study to examine if differential uropathogen specific virulence factors are expressed among pregnant women with urinary tract infections during pregnancy. 114 prospectively identified E. coli UTIs were identified: 37 asymptomatic bacteruria (ASB), 26 acute bacterial cystitis (ABC), 14 acute pyelonephritis (APN) and 37 urosepsis (US) cases. There were no differences in the pathogen-specific virulence factors expressed across the clinical outcomes spectrum identified suggesting host rather than pathogen-specific causes for the clincal presentations seen.



July 5, 2012 at 10:47 am

Infectious Diseases Society of America guidelines for the diagnosis and treatment of asymptomatic bacteriuria in adults.

Clin Infect Dis. 2005 Mar 1  V.40 N.5  P.643-54.

Nicolle LE, Bradley S, Colgan R, Rice JC, Schaeffer A, Hooton TM; Infectious Diseases Society of America; American Society of Nephrology; American Geriatric Society.

University of Manitoba, Health Sciences Centre, Winnipeg, Manitoba, Canada.


July 5, 2012 at 10:43 am


July 2012

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