scholarly journals Primary results of a prospective comparative non-interventional study for the treatment of asymptomatic bacteriuria in pregnant women

2021 ◽  
Vol 14 (1) ◽  
pp. 124-128
Author(s):  
S.V. Shkodkin ◽  
◽  
N.A. Fliginskikh ◽  
N.V. Zhdanovskaya ◽  
L.F. Li ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Methodological Quality ◽  
Randomized Clinical Trials ◽  
Urine Analysis ◽  
Asymptomatic Bacteriuria ◽  
Herbal Medicines ◽  
Evidence Base ◽  
Vaginal Microbiota ◽  
Vaginal Candidiasis ◽  
Vaginal Smears

Introduction. Over the past three decades, the views on the diagnosis and treatment of asymptomatic bacteriuria in pregnant women have not undergone any changes. However, the majority of randomized clinical trials concerning the treatment of pathients with this nosology are of low methodological quality and date back to the 60-80s. Since then, diagnostic and treatment protocols have changed dramatically, so the quality of the evidence base is low. In a recent Scandinavian study of higher methodological quality, there was no clear benefit of antibiotic therapy in pregnant women with asymptomatic bacteriuria. Material and methods. This publication is devoted to the interim results of a study that analyzed the efficacy and safety of herbal medicinal product Canephron® N in the treatment of asymptomatic bacteriuria in 29 pregnant women aged 22 to 34 years at a gestation period of 14-28 weeks. When included in the study, as well as on days 14, 30 and 60, the following laboratory control was performed: general urine analysis, urine bacteriological examination, clinical analysis of vaginal smears, analysis of vaginal microbiota by quantitative PCR Results. In the group of our patients, the distributions by age and gestational age differed from normal, the mean values are presented by the median and were 29 years and 14 weeks, respectively. Already had children – 13 (44.8%) women. In total, 35 microorganisms were isolated in a diagnostically significant titer. Most of the representatives of the Enterococcaceae family were traditionally 57.1%. At the time of inclusion, the median pyuria was 2.5 μl and exceeded the reference values only in 10.3% of patients. Clinical examination of vaginal smears revealed no inflammatory changes. However, an assessment of the vaginal microbiota showed the presence of dysbiosis due to an increase in the amount of obligate-anaerobic microflora in 58.6% and vaginal candidiasis in 10.3% of pregnant women. After 2 months, the 28 pregnant women remaining in the study had no episodes of symptomatic urinary infection. During the herbal drug therapy, there was a decrease in diagnostically significant bacteriuria and signs of the inflammatory process in all patients. The frequency of vaginal dysbiosis was recorded in 10.7% of pregnant women (р>0,05). Conclusion. Thus, our preliminary results shows that the use of Canephron N in pregnant women with asymptomatic bacteriuria (ABU) may be an effective alternative approach comparing the use of antibiotics. The treatment with Canephron N promotes the normalization of the urinary tract microflora and save the intactness of the saprophytic flora, in contrast to antibacterial drugs, and this is especially important in the paradigm of the antibiotics stewardship and the fight against growing antibiotic resistance. Comparative results of the use of antibacterial agents and Canephron N will be analyzed in the next publication, on the basis of which final conclusions will be drawn about the advisability of using herbal medicines to control bacteriuria in pregnant women Conclusion. We have obtained encouraging results from the use of Canephron-N® in patients with asymptomatic bacteriuria in pregnant. To obtain an evidence base of a recommendatory level, it is advisable to increase the number of observations.

scholarly journals Asymptomatic Bacteriuria and Antibacterial Susceptibility Patterns in an Obstetric Population

2011 ◽  
Vol 2011 ◽  
pp. 1-4 ◽  
Author(s):  
Şevki Çelen ◽  
Ayla Sargin Oruç ◽  
Rana Karayalçin ◽  
Sibel Saygan ◽  
Serpil Ünlü ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Urine Analysis ◽  
Asymptomatic Bacteriuria ◽  
High Sensitivity ◽  
Klebsiella Pneumonia ◽  
Low Birth Weight Infants ◽  
E Coli ◽  
Antibacterial Susceptibility ◽  
Obstetric Population ◽  
Associated Risk Factors

Introduction. Asymptomatic bacteriuria (ASB), occurring in 2–11% of pregnancies, is a major predisposition to the development of pyelonephritis, which is associated with obstetrical complications, such as preterm labor and low birth weight infants. The aim of this study was to determine the prevalence of ASB, the antibacterial susceptibilities of the isolated microorganisms and the associated risk factors in an outpatient clinical setting in Zekai Tahir Burak Women's Health Education and Research Hospital in Ankara, Turkey. Material and Methods. Between December 2009 and May 2010, pregnant women admitted to the antenatal outpatient clinic were included in this study. The results of a complete urine analysis, midstream urine culture and antibacterial susceptibility were evaluated. Results. Of the 2011 pregnant women included, 171 had ASB (8.5%). E. coli was the most frequently isolated microorganism (76.6%), followed by Klebsiella pneumonia (14.6%). Both microorganisms were highly sensitive to fosfomycin, sensivity being 99.2% for E. coli and 88% for Klebsiella pneumonia. Conclusions. In this certain geographical region, we found E. coli as the most common causative agent of ASB in the obstetric population and it is very sensitive to fosfomycin. We recommend fosfomycin for ASB in pregnant women due to its high sensitivity, ease of administration and safety for use in pregnancy.

scholarly journals The Rate of Asymptomatic Bacteriuria is Similar in Term and Preterm Delivery

2016 ◽  
Author(s):  
Riska Amelia
Keyword(s):  
Pregnant Women ◽  
Preterm Delivery ◽  
Preterm Labor ◽  
Obstet Gynecol ◽  
Urine Analysis ◽  
Urine Culture ◽  
Asymptomatic Bacteriuria ◽  
Significant Difference ◽  
Term Delivery ◽  
The Subject

Objectives: To show the prevalence of asymptomatic bacteriuria in pregnant women and to find its correlation with preterm labor. Methods: This research was performed in Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia. A total of 78 subjects joined this research. The first group consisted of 39 subjects that were having preterm delivery and the second group consisted of 39 subjects that were having term delivery. Urine analysis and culture were done in both groups. The subject was being considered to have asymptomatic bacteriuria if the urine culture showed a minimum of 100,000 bacteria/ml without any symptoms or signs of urinary tract infection. The number was then analyzed to reveal the correlation of asymptomatic bacteriuria with preterm delivery. Results: There were a significantly higher number of preterm deliveries in subjects whose age ranged between 15-19 year-old (28.20% vs 12.8%; p=0.033). While on the contrary, there was a significantly lower number of preterm delivery in subjects whose age ranged between 30-34 year-old (25.6% vs 5.12%; p=0.020).The incidence number of asymptomatic bacteriuria among all subjects is 21.79%. There was no significant difference of asymptomatic bacteriuria between preterm and a term delivery (23.07% vs 20.51%; p=0.784). Conclusions: There was no significant difference of asymptomatic bacteriuria between the subject with preterm delivery and term delivery, but the incidence of asymptomatic bacteriuria in pregnant women in this study was quite high, reaching eight times higher than those stated in other study. Thus, routine urine culture screening policy in early pregnancy still cannot be omitted, considering that asymptomatic bacteriuria can lead to pyelonephritis which can cause maternal and fetal morbidity. [Indones J Obstet Gynecol; 37-1: 8-11] Keywords: asymptomatic bacteriuria, urine analysis, urine culture, preterm delivery

scholarly journals Chinese Herbal Medicines Compared with N-Acetylcysteine for the Treatment of Idiopathic Pulmonary Fibrosis: A Systematic Review of Randomized Controlled Trials

2019 ◽  
Vol 2019 ◽  
pp. 1-18
Author(s):  
Jing Guo ◽  
Bin Li ◽  
Wenbin Wu ◽  
Zhichao Wang ◽  
Fei Wang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Idiopathic Pulmonary Fibrosis ◽  
Pulmonary Fibrosis ◽  
Methodological Quality ◽  
Randomized Clinical Trials ◽  
Conventional Medicine ◽  
Herbal Medicines ◽  
Chinese Herbal

Background. Idiopathic pulmonary fibrosis (IPF) is a major global health problem. The prevalence of the disease appears to be increasing. There is no curative therapy for IPF except lung transplantation. Chinese herbal medicines (CHMs) are showing promise for treatment of IPF. However, their effectiveness and safety are still unclear and deserve further investigation. The aim of this systematic review is to access the efficacy and safety of CHMs in treating IPF. Methods. The protocol of this review is registered at PROSPERO. We searched seven main databases for randomized clinical trials (RCTs) on CHMs for IPF from their inception to June 4, 2018. The methodological quality of RCTs was assessed using the Cochrane risk of bias tool. All trials included were analyzed according to the criteria of the Cochrane Handbook. Review Manager 5.3, R-3.5.2 software, and Grade pro GDT web solution were used for data synthesis and analysis. Results. Thirteen randomized clinical trials enrolling 733 patients were included. All trials included had clear outcome indicators. The methodological quality of included trials was generally “poor.” Few trials reported methods of randomization. One trial on Xuefu-zhuyu capsule assessed rate of acute exacerbation and mortality after treatment for 72 weeks and found no statistically significant difference between two groups. This meta-analysis demonstrated a significant improvement in QOL of IPF patients when CHMs was applied or combined with conventional medicine treatment. 6MWT was significantly improved in IPF patients after using CHMs or combined with conventional medicine treatment. CHMs treatment also had a certain improvement in TLC and DLCO, but the effect on FVC was not significant. Besides, CHMs failed to provide benefits in terms of PaO2. The reported adverse events were not obvious and severe. Conclusions. Some CHMs seem effective and safe as alternative remedies for patients with IPF, suggesting that further study of CHMs in the treatment of IPF is warranted. Although this systematic review suggests that CHMs may have positive effect on quality of life, 6-minute walk test distance, and lung function (TLC, DLOC%) and seem to be relatively safe during the course of treatment, the results must be treated with great caution because of the methodological flaws of the included trials. Long-term and high-quality trials are needed in the future to provide clear evidence for the use of CHMs.

scholarly journals Features of the vaginal microbiota and ways of correction of its disorders in case of full-term pregnancy

2020 ◽  
pp. 38-43
Author(s):  
Z. S. Zaydiyeva ◽  
M. K. Medzhidova
Keyword(s):  
Pregnant Women ◽  
Treatment Method ◽  
Full Term ◽  
Vaginal Microbiota ◽  
Vaginal Candidiasis ◽  
Good Effect ◽  
Term Pregnancy ◽  
Quick Method ◽  
Vaginal Microflora ◽  
Wide Range

Introduction. The vaginal microflora has a direct impact on the health of a newborn child, as well as during the postpartum period in new mothers. The composition of the vaginal microflora of a new mother determines the microflora of her conjunctiva, gastrointestinal tract, and the skin of the newborn, which are identical to the microflora of the mother’s birth canal, and the risk of infection in newborns is directly related to the degree of amniotic fluid insemination. At least half of women have some kind of vaginal microcenosis disorder during pregnancy. In the course of the study, the peculiarities of vaginal microbiota in a full-term pregnancy were studied and the effectiveness of correction of vaginal microcenosis abnormalities when applying the preparation Gaynomax was assessed.Aim of the study. To study the peculiarities of the vaginal microbiota in case of full-term pregnancy and to evaluate the effectiveness of correction of its abnormalities when applying the preparation Gaynomax.Materials and methods. On the basis of City Clinical Hospital No. 40, separate subdivision “Maternity hospital“, clinical and diagnostic department 72 pregnant women in the gestation period of 37-39 weeks the analysis of microscopic examination of vaginal swabs culture and sensitivity test was performed. The analysis included the results of a microscopic study of vaginal and cervical swabs stained using the Gram method. Bacteriological analysis of the vaginal content by cultivating aerobic and anaerobic microorganisms on special nutrient media. PCR method with real-time detection of results (Femoflor 16), including the determination of a wide range of microorganisms. To obtain adequate results, only samples with a sufficient number of cells caught in the test tube with the analyzed sample and sufficient total bacterial mass were used. Samples in which the number of DNA of human cells was more than 104 genome equivalents (GE) in the sample were taken into account, this is a swab quality indicator (SQI).The results: In pregnant women with high frequency infectious risk group, vaginal dysbitoic conditions were revealed with development of bacterial vaginosis, vaginal candidiasis and nonspecific vaginitis. Vaginal sanitation was carried out in patients. Excellent effect was obtained in 33/72 (49,2%) women, good effect in 21/72 (31,4%) patients, satisfactory in 13/72 (19,4%), which indicates fully justified expectations from the chosen treatment method. Conclusion: The use of Gaynomax vaginal suppositories is a reasonable and quick method of vaginal sanitation before delivery.

scholarly journals Break through Host Defense: UTI in Pregnant Women in Compare to Non Pregnant

2021 ◽  
Author(s):  
Muhamed Ali Al Kabe ◽  
Eman Th. Nadhaif Al-Fatlawy
Keyword(s):  
Urinary Tract ◽  
Pregnant Women ◽  
Urinary Tract Infections ◽  
Urine Analysis ◽  
Previous History ◽  
Asymptomatic Bacteriuria ◽  
Urine Examination ◽  
Mother And Child ◽  
History Of ◽  
Tract Infections

Urinary tract infections (UTIs) are common in pregnant women and provide a substantial therapeutic challenge due to the high potential of serious effects for both the mother and the baby. Pregnancy affects the urinary system physiologically, anatomically, and functionally, which can lead to infections emerging from the urethra. Unlike the general population, all pregnant women should have their urine cultures examined for bacteriuria, and any cases of asymptomatic bacteriuria should be treated, as it is a major risk factor for pyelonephritis in this group. Both the mother and the fetus should be safe from the antibiotic administered. To determine the prevalence of UTI in pregnancy in compare to non-pregnant woman in Wasit province to roll out the impact of pregnancy on the frequency of UTI. A case–control study between 2019 July and 2019 September was carried out on 30 pregnant women in compare to 30 matched non pregnant women were attending Al-Zahraa teaching hospital. A randomized (Every member of a population has the same probability of being picked for the sample, as do all possible samples of a given size) age, employment, present history, previous history, obstetric history, sex partner, frequency of sexual intercourse, and peeing frequency were all analyzed separately utilizing a plate form questioner. Urine samples, as well as a regular urine examination and urine culture, were obtained from the women who were being studied. Bacteriouria was shown to be prevalent in 13.3% of women, 16.7% of pregnant women, and 10% of non-pregnant women in this research. Asymptomatic bacteriuria in all women was 5/60 cases 8.3%. This indicates that about 16.7% of pregnant women are at risk of development of acute episode of UTI during pregnancy if they are not properly treated. In pregnant women, urinary tract infections (UTIs) are still a prevalent concern, particularly in the second trimester. During the prenatal period, urinalysis is necessary for all pregnant women. Early diagnosis and treatment of asymptomatic bacteriuria will be aided by the screening, preventing complications for both mother and child. The most prevalent risk factors for UTI during pregnancy were poor personal cleanliness, a history of UTI, diabetes mellitus, and anemia. As a result, the study suggests that pregnant women get health education on personal sanitary cleanliness, be advised not to overuse antibiotics, and undergo frequent comprehensive urine analysis.

scholarly journals Asymptomatic bacteriuria in pregnant women attending Boo-Ali Hospital Tehran Iran: Urine analysis vs. urine culture

10.19082/5760 ◽  
2017 ◽  
Vol 9 (11) ◽  
pp. 5760-5763 ◽  
Author(s):  
Mina Etminan-Bakhsh ◽  
Sima Tadi ◽  
Mitra Mohit ◽  
Roksana Darabi
Keyword(s):  
Pregnant Women ◽  
Urine Analysis ◽  
Urine Culture ◽  
Asymptomatic Bacteriuria

Clinical and microbiological aspects of vaginal microbiota at pregnant with threat of late miscarriages during treatment with vaginal gestagens forms

2017 ◽  
pp. 68-73
Author(s):  
I.P. Polishchuk ◽  
Keyword(s):  
Pregnant Women ◽  
Therapeutic Effect ◽  
Local Treatment ◽  
Vaginal Microbiota ◽  
Control Group ◽  
Before And After ◽  
Low Efficiency ◽  
Late Miscarriage ◽  
Microbiological Aspects ◽  
Micronized Progesterone

The objective: was to examine the effectiveness of treatment of late miscarriage threat by micronized form of progesterone for 100 mg – 3 times a day in the form of gelatin pills and vaginal tablets with lactose. Patients and methods. Under our supervision there were 70 pregnant women with normocenosis of vagina (NCV) without extragenital pathology, which were not performed systemic or local treatment with antibacterial drugs in the last 4 weeks. Among them 25 pregnant women with TLSM treated by gelatin tablets of micronized progesterone (GTP) (group 1); 25 pregnant women with TLSM, treated by vaginal micronized progesterone tablets (VPT) (2nd group) and 20 healthy women with physiological pregnancy – PV (control group). The distribution of women in the group adhered to the principles of randomization. The age of examined women ranged from 19 to 32 years, most pregnant women were aged under 30 years (89.02%). General clinical examination was carried out according to the standard scheme according to the Order MH of Ukraine № 620. Results. During the research we have determined the colpocytologcal dynamics and state of vaginal microbiota in pregnant women with threatened late miscarriage with initial vaginal normocenosis before and after treatment whit vaginal forms of progesterone. Conclusion. The received results showed low efficiency of micronized progesterone gelatin dragee at threat of the late miscarriage that at small therapeutic effect has led to the development of vaginal dysbiosis in all surveyed. In contrast, the use of micronized progesterone vaginal tablets – the maximally rapid therapeutic effect without disturbance of vaginal normocenosis. Key words: the threat of a late miscarriage, vaginal micronized forms of progesterone.

Disputable issues of diagnosing and treatment of asymptomatic bacteriuria in pregnant women

2018 ◽  
Vol 16 (6) ◽  
pp. 34-38
Author(s):  
T. P. Zefirova ◽  
◽  
M. E. Zhelezova ◽  
I.I. Akhmetshina ◽  
◽  
...  
Keyword(s):  
Pregnant Women ◽  
Asymptomatic Bacteriuria

Non-Vitamin K Antagonist Oral Anticoagulants in Pulmonary Embolism: An Overview of Systematic Reviews

2020 ◽  
Vol 26 (23) ◽  
pp. 2686-2691 ◽  
Author(s):  
Ioannis Doundoulakis ◽  
Christina Antza ◽  
Haralambos Karvounis ◽  
George Giannakoulas
Keyword(s):  
Pulmonary Embolism ◽  
Vitamin K ◽  
Systematic Reviews ◽  
Methodological Quality ◽  
Randomized Clinical Trials ◽  
Oral Anticoagulants ◽  
Vitamin K Antagonist ◽  
Language Restriction ◽  
Overview Of Systematic Reviews

Background: Anticoagulation in patients with pulmonary embolism. Objective: To identify how non-vitamin K antagonist oral anticoagulants are associated with multiple outcomes in patients with pulmonary embolism. Methods: We performed a systematic search of systematic reviews via multiple electronic databases from inception to August 19th, 2019, without language restriction. Two authors independently extracted data and assessed the methodological quality of the included systematic reviews using the ROBIS tool. Results: We found twelve systematic reviews. Eleven SRs collected their data from randomized clinical trials and one from observational studies. All the included studies were published between 2014 and 2019 in English. The methodological quality of the 12 systematic reviews was low to high. None of the systematic reviews, which are included in our overview of systematic reviews, has evaluated the overall quality of evidence outcome using the Grading of Recommendations Assessments, Development and Evaluation (GRADE) approach. Conclusion: This is the first effort to summarize evidence about non-vitamin K antagonist oral anticoagulants in an overview of systematic reviews focusing exclusively on patients with pulmonary embolism. The evidence suggests that the non-vitamin K antagonist oral anticoagulants seem to be more effective and safer than a dualdrug approach with LMWH- VKA.

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