Above 80% of urinary tract infections are caused by enteric bacteria, which are known for years by their drug-resistant ability. Though the prevalence of drug-resistant strains is increasing in the world, it is not well known in low-income countries. The aim of this study was to assess the prevalence of Multi-drug resistance, Extended-spectrum β-lactamases production, and associated risk factors among pregnant women in Northwest Ethiopia. A hospital-based cross-sectional study was conducted among pregnant women from March to May 2017. A total of 384 clean-catch midstream urine sample was collected from study participants. Bacterial identification and drug susceptibility testing were done following standard microbiological techniques; Extended-spectrum β-lactamase production was screened using a disc diffusion test and confirmed by a combination disc test. The data were entered and analyzed by using SPSS version 20, and a p-value of less than 0.05 was considered as statistically significant. The overall prevalence of urinary tract infection was 15.9% (95% CI 12.8–20.1%). E. coli (49.2%), CoNS (27.9%), and S. aureus (18%) were the main uropathogens. The prevalence of MDR uropathogens was 60.65%. The prevalence of ESBLs production among cases caused by Enterobacteriaceae was 18.2%. The drug resistance rate of Gram-negative isolates was higher for ampicillin (90.9%), cephalothin (84.8%), and augmentin (57.6%). The drug nitrofurantoin showed the highest activity (100%) against Gram-negative isolates. Gram-positive isolates were showed low susceptibility to penicillin (89.3%) and cotrimoxazole (75%); however highest susceptibility rate for gentamicin (100%), amikacin (100%), and nitrofurantoin (98.36%) was recorded. Prior antibiotic therapy (AOR = 5.46, 95% CI 1.38–21.65) was a risk factor for the presence of multi-drug resistant bacteria. The multi-drug resistance prevalence was high among uropathogen, thus treatment of urinary tract infection during pregnancy; should be based on the antibacterial susceptibility testing result. The isolation of drug-resistant strains like Extended-spectrum β-lactamases in this study calls for the need of periodic and continuous follow-up of antibiotic usage among pregnant women. Nitrofurantoin, gentamicin, amikacin, and ciprofloxacin/norfloxacin showed higher activity against bacterial uropathogen.

中文翻译：

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埃塞俄比亚西北部孕妇中产生细菌性尿路病原体的多重耐药性和广谱β-内酰胺酶。

80%以上的尿路感染是由肠道细菌引起的，多年来人们都知道肠道细菌具有耐药性。尽管耐药菌株在世界范围内的流行率正在增加，但在低收入国家却并不为人所知。本研究的目的是评估埃塞俄比亚西北部孕妇的多重耐药性、广谱 β-内酰胺酶的产生以及相关危险因素的患病率。2017 年 3 月至 5 月，在孕妇中进行了一项以医院为基础的横断面研究。从研究参与者中收集了总共 384 份干净捕获的中流尿液样本。细菌鉴定和药敏试验按照标准微生物学技术进行；使用纸片扩散试验筛选超广谱 β-内酰胺酶的产生，并通过组合纸片试验进行确认。使用 SPSS 20 版输入和分析数据，p 值小于 0.05 被认为具有统计显着性。尿路感染的总体患病率为 15.9% (95% CI 12.8–20.1%)。大肠杆菌（49.2%）、CoNS（27.9%）和金黄色葡萄球菌（18%）是主要的尿路病原体。耐多药尿路病原体的患病率为60.65%。肠杆菌科细菌引起的病例中ESBLs产生率为18.2%。革兰阴性菌对氨苄青霉素(90.9%)、头孢噻吩(84.8%)、安美汀(57.6%)的耐药率较高。呋喃妥因药物对革兰氏阴性菌株表现出最高的活性（100%）。革兰氏阳性菌株对青霉素（89.3%）和复方新诺明（75%）的敏感性较低；然而，庆大霉素（100%）、阿米卡星（100%）和呋喃妥因（98.36%）的敏感性最高。既往抗生素治疗（AOR = 5.46，95% CI 1.38–21.65）是存在多重耐药细菌的危险因素。尿路病原体多重耐药率较高，需治疗妊娠期尿路感染；应以药敏试验结果为准。本研究中分离出广谱β-内酰胺酶等耐药菌株，需要定期、持续跟踪孕妇抗生素的使用情况。呋喃妥因、庆大霉素、阿米卡星和环丙沙星/诺氟沙星对细菌性尿路病原体表现出较高的活性。