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

Disclosures:

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.