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.
K. Riesenberg, None
L. Nesher, None
L. Saidel-Odes, None
A. Borer, None
R. Smolyakov, None