Objectives

Different microorganisms contribute in the pregnancy bacteriuria, which resistance microorganisms limited the therapeutic options for the treatment and increasing the related risks to pregnant women and their pregnancy. Based on this, asymptomatic bacteriuria and the use of inappropriate empirical antibiotics are dangerous in the emergence of pregnancy complications and the incidence of drug resistant.

Methods

A comprehensive systematic search was performed on all international databases including Scopus, PubMed, Web of Science, Medline, Cochrane library during 2000 – June 2019. This meta-analysis, which was registered by a pre-defined protocol in PROSPRO, carried out in accordance with PRISMA guideline. Relevant articles were included in the analysis if reported the susceptibility pattern of antimicrobial resistance related to asymptomatic bacteria in pregnant women with no acute diseases. Overall prevalence and related 95% confidence interval for resistance in different asymptomatic infections were estimated by inverse variance method. The random effect model was used in case of considerable heterogeneity.

Results

Results of this analysis demonstrated different resistance rate against studied classes of antibiotics. Nitrofurantoin resistance in E. coli, Klebsiella sp, P. aeruginosa, and Staphylococcus aureus isolates were estimated 0.22 (95%CI: 0.15–0.30), 0.40 (95%CI: 0.26–0.54), 0.81 (95%CI: 0.59–0.97), 0.34 (0.11–0.63), respectively. Subgroups analysis showed highest resistance in E. coli isolates, in Asia and Africa against Cefotaxime and Ampicillin, respectively.

Conclusion

In summary, increasing resistance rate in urinary tract infection (UTI)-related agents is a risk factor that endangers both mother and fetus. Health care providers should consider screening as the radical part of infection control strategies. Due to low resistance rate to Nitrofurantoin, this drug can be a good choice for UTI treatment in pregnancies, but it should use with caution

中文翻译：

---

孕妇无症状菌尿的抗生素耐药性概况：系统评价和荟萃分析。

目标

不同的微生物促成妊娠菌症，这些抗药性微生物限制了治疗的治疗选择，并增加了孕妇及其怀孕的相关风险。基于此，无症状菌尿和使用不合适的经验性抗生素对怀孕并发症的发生和耐药性的发生是危险的。

方法

在2000年至2019年6月期间，对所有国际数据库（包括Scopus，PubMed，Web of Science，Medline，Cochrane图书馆）进行了全面的系统搜索。该荟萃分析已通过PROSPRO中的预定义协议进行了注册，并根据符合PRISMA准则。如果报告了无急性疾病的孕妇中与无症状细菌有关的抗菌素耐药性敏感性模式，则相关文章也包括在分析中。通过逆方差方法估计了不同无症状感染的总体耐药率和相关的95％置信区间。如果异质性很大，则使用随机效应模型。

结果

该分析结果表明，对研究的抗生素类别的耐药率不同。在呋喃妥因性ë。大肠杆菌，克雷伯菌，铜绿假单胞菌和金黄色葡萄球菌的分离株估计为0.22（95％CI：0.15–0.30），0.40（95％CI：0.26-0.54），0.81（95％CI：0.59–0.97），0.34（ 0.11-0.63）。亚组分析显示，在亚洲和非洲的大肠杆菌分离物中，对头孢噻肟和氨苄青霉素的耐药性最高。

结论

总之，在尿路感染（UTI）相关药物中耐药率的增加是危害母亲和胎儿的危险因素。卫生保健提供者应将筛查视为感染控制策略的根本部分。由于对呋喃妥因的耐药率低，该药物可能是妊娠期UTI治疗的不错选择，但应谨慎使用