Diagnostic and Treatment Difficulties of Pyelonephritis in Pregnancy in Resource-Limited Settings
| Autor: | Stuart D. Blacksell, Saw Oo Tan, Nicholas J. White, Vanaporn Wuthiekanun, Sharon J. Peacock, Elizabeth A. Ashley, Samuel Jacher Viladpai-nguen, Mupawjay Pimanpanarak, François Nosten, Wilarat Jesadapanpong, Pratap Singhasivanon, Stephane Proux, Rose McGready, Nicholas P. J. Day |
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| Rok vydání: | 2010 |
| Předmět: |
medicine.medical_specialty
03 medical and health sciences 0302 clinical medicine Pregnancy Risk Factors Virology Ampicillin Drug Resistance Bacterial medicine Humans Blood culture 030212 general & internal medicine Pregnancy Complications Infectious Intensive care medicine 030219 obstetrics & reproductive medicine Bacteria Pyelonephritis medicine.diagnostic_test Obstetrics business.industry Sulfamethoxazole Articles Amoxicillin Thailand medicine.disease Trimethoprim Anti-Bacterial Agents 3. Good health Ciprofloxacin Infectious Diseases Female Parasitology business Malaria medicine.drug |
| Zdroj: | The American Journal of Tropical Medicine and Hygiene |
| ISSN: | 1476-1645 0002-9637 |
| DOI: | 10.4269/ajtmh.2010.10-0332 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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