ASSOCIATION OF URINARY TRACT INFECTION WITH PRETERM LABOUR: PREVALENCE AND BACTERIOLOGICAL PROFILE
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Keywords
Preterm labour, Urinary tract infection, Asymptomatic bacteriuria, Escherichia coli, Antibiotic resistance.
Abstract
Background: Preterm labour is a leading cause of neonatal morbidity and mortality worldwide. Among preventable factors, urinary tract infection (UTI) plays a major role by triggering inflammatory pathways that induce uterine contractions and preterm birth. This study aimed to determine the prevalence of UTI among women with preterm labour and to evaluate the bacteriological spectrum and antibiotic susceptibility pattern of isolated organisms.
Methods: A prospective observational study was conducted at the Departments of Obstetrics and Gynaecology,Pathology & Microbiology, Government Medical College, Haldwani over 18 months. 167 pregnant women with preterm labour (28–36+6 weeks gestation) were included after informed consent. Midstream urine samples were sent for routine microscopy and cultured on CLED and MacConkey agar, and isolates were identified by standard microbiological methods. Antibiotic susceptibility testing was performed using the Kirby–Bauer disk diffusion method as per CLSI 2024 guidelines.
Results: UTI was detected in 28.74% of participants, with asymptomatic bacteriuria (23.35%) more frequent than cystitis (5.39%). Escherichia coli was the most common pathogen (75%), followed by Klebsiella spp. (14.58%), Proteus mirabilis (6.25%), and Staphylococcus aureus (4.17%). The highest sensitivity was observed to amikacin (70.83%), nitrofurantoin (66.67%), and amoxicillin–clavulanate (62.5%), while marked resistance occurred to ciprofloxacin (60.42%) and ampicillin (39.58%).
Conclusion: UTI is a frequent and preventable cause of preterm labour. Routine urine culture and microscopy screening and culture-guided antibiotic therapy are essential to reduce infection-related preterm births and improve perinatal outcomes.
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Dr Prof Godawari Joshi
Professor & Head of Department, Department of Obstetrics & Gynaecology, Government Medical College, Haldwani, Uttarakhand
Dr. Indu Bartwal
JR-3 Obstetrics & Gynaecology Department, Government Medical College, Haldwani, Uttarakhand
Dr.Mahima Rani
Associate professor, Department of obstetrics and gynaecology, Government Medical College, Haldwani , Uttarakhand
Dr H.S Pandey
Professor and Head of department, Department of Pathology, Government Medical College, Haldwani,Uttarakhand
Dr.Shambhavi
Assitant professor, Department of Microbiology, Government Medical College, Haldwani,Uttarakhand
