1798. The Meaning of Isolating ESBL Enterobacteriaceae From The Urine of Pregnant Women, a Matched Case Control Study
Session: Oral Abstract Session: Resistance is Futile
Saturday, October 29, 2016: 11:48 AM
Room: 288-290
Background: Extended-spectrum-beta lactamase producing enterobacteriaceae (ESBL-E) pose a serious public threat. Lately there is an increase in the prevalence of these pathogens. It is believed that urinary tract infections (UTI)/asymptomatic bacteriuria (ABU) in pregnancy, left untreated, are associated with poor obstetric outcomes. Currently, there is no data regarding the outcomes of ESBL UTI/ABU in pregnant women.

Methods: We conducted a matched 2:1 case-control study of pregnant women with ESBL-E vs. non ESBL-E infections between 2004 and 2015. We compared data on risk factors for the development of resistant bacterial infection, antibiotic treatment and clinical outcomes in both groups.

Results: 87 pregnant women with ESBL-E were identified, and matched to 174 controls. A 15 fold rise in resistant isolates was found during the study period. No significant difference was found in adverse pregnancy outcomes including : low birth weight, pre-term labor and other obstetric complications between the groups. A significant difference was found in prior antibiotic exposure (69% vs 50.6% p=0.005) prior isolation of ESBL-E (12% vs. 0.6% P<0.001) and recurrent UTI (10% vs. 2.5% P=0.01). No difference was found in previous health care exposure. Interestingly, 25% of women in the case group were inadequately treated for their infection. We found no significant difference in pregnancy outcomes between treated and inadequately treated women.

Conclusion:We found that there is a rise in community acquired ESBL-E infections. Nevertheless, ESBL-E infections were not associated with a poor pregnancy outcome compared to standard UTI/ABU. In pregnant women, a young and relatively healthy population, previous antibiotic exposure, recurrent UTI and prior ESBL-E, were found to be significant risk factors for ESBL-E infection. As no difference was found in the outcomes of a small sub group of inadequately treated patients, further study is required on the importance of antibiotic treatment for every ESBL-E isolation.

Yael Yagel, MD, Hilli Nativ, MD, Klaris Riesenberg, MD, Lior Nesher, MD, Lisa Saidel-Odes, MD, Abraham Borer, MD and Rozalia Smolyakov, MD, Infectious Disease Institute, Soroka University Medical Center, Beer Sheba, Israel


Y. Yagel, None

H. Nativ, None

K. Riesenberg, None

L. Nesher, None

L. Saidel-Odes, None

A. Borer, None

R. Smolyakov, None

See more of: Resistance is Futile
See more of: Oral Abstract Session
<< Previous Abstract | Next Abstract

Findings in the abstracts are embargoed until 12:01 a.m. CDT, Wednesday Oct. 26th with the exception of research findings presented at the IDWeek press conferences.