Document Detail

Diagnostic and treatment difficulties of pyelonephritis in pregnancy in resource-limited settings.
MedLine Citation:
PMID:  21118943     Owner:  NLM     Status:  MEDLINE    
Limited microbiology services impede adequate diagnosis and treatment of common infections such as pyelonephritis in resource-limited settings. Febrile pregnant women attending antenatal clinics at Shoklo Malaria Research Unit were offered urine dipstick, sediment microscopy, urine culture, and a 5-mL blood culture. The incidence of pyelonephritis was 11/1,000 deliveries (N = 53 in 4,819 pregnancies) between January 7, 2004 and May 17, 2006. Pyelonephritis accounted for 20.2% (41/203) of fever cases in pregnancy. Escherichia coli was the most commonly isolated pathogen: 87.5% (28/32) of organisms cultured. Susceptibility of E. coli to ampicillin (14%), cotrimoxazole (21%), and amoxicillin-clavulanic acid (48%) was very low. E. coli was susceptible to ceftriaxone and ciprofloxacin. The rate of extended spectrum β-lactamase (4.2%; 95% confidence interval = 0.7-19.5) was low. The rate and causes of pyelonephritis in pregnant refugee and migrant women were comparable with those described in developed countries. Diagnostic innovation in microbiology that permits affordable access is a high priority for resource-poor settings.
Rose McGready; Vanaporn Wuthiekanun; Elizabeth A Ashley; Saw Oo Tan; Mupawjay Pimanpanarak; Samuel Jacher Viladpai-Nguen; Wilarat Jesadapanpong; Stuart D Blacksell; Stephane Proux; Nicholas P Day; Pratap Singhasivanon; Nicholas J White; François Nosten; Sharon J Peacock
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The American journal of tropical medicine and hygiene     Volume:  83     ISSN:  1476-1645     ISO Abbreviation:  Am. J. Trop. Med. Hyg.     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-12-01     Completed Date:  2011-01-11     Revised Date:  2014-08-12    
Medline Journal Info:
Nlm Unique ID:  0370507     Medline TA:  Am J Trop Med Hyg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1322-9     Citation Subset:  AIM; IM    
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MeSH Terms
Anti-Bacterial Agents / pharmacology,  therapeutic use*
Bacteria / classification,  drug effects
Drug Resistance, Bacterial
Pregnancy Complications, Infectious / diagnosis*,  economics,  therapy*,  urine
Pyelonephritis / diagnosis*,  economics,  therapy*,  urine
Risk Factors
Thailand / epidemiology
Grant Support
093956//Wellcome Trust; //Wellcome Trust
Reg. No./Substance:
0/Anti-Bacterial Agents

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