Agentes etiológicos bacterianos de infecção do trato urinário em gestantes da rede pública de Manaus

Abstract

OBJECTIVE: To determine the prevalence of urinary tract infection in pregnant women seen at a laboratory in the municipal public network of Manaus. METHOD: Cross-sectional, retrospective study with a quantitative approach and description of the etiological aspects of urinary tract infection in pregnant women monitored in a laboratory in the municipal public network of Manaus, from January 2016 to December 2018. A total of 5,926 reports of urine cultures were evaluated. of pregnant women. The reports that were included in the study met the inclusion criteria: reports with positive and negative results of samples for microbiological urine culture of pregnant women in the 2016 to 2018 triennium; completed reports of samples, from the Health Districts, of pregnant women who underwent prenatal care in the city of Manaus, regardless of age and/or gestational age, with medical/nursing request in the public network. Reports of pregnant women with medical/nursing requests from basic health units linked to the Rural District were excluded, considering that the study refers exclusively to the municipality of Manaus. The collection took place in the form of retrospective and in situ data collection, obtaining the data: month of the sample analyzed, year, Health District that sent the sample, age of the user, gestational age, according to the quarter and the result of the report. The study database was built using Microsoft Excel software, with data analysis using the Statistical Program R, applying the Chi-Square test, considering a significance of p <0.05. The study was approved by the Research Ethics Committee of the State University of Amazonas, CAAE: 85129318.2.0000.5016. RESULTS: 31 species of bacterial etiological agents causing urinary tract infections were identified in pregnant women from the public network in the city of Manaus. It was observed that 22.3% (n = 1322) of the samples were positive and that Escherichia coli is the most prevalent etiological agent in pregnant women, 33.6% (n = 444) in at least three districts of the city (p = 0.0013), followed by Streptococcus sp, Klebsiella pneumoniae and Enterococcus faecalis. CONCLUSION: Thirty-one species of bacterial etiologic agents causing Urinary Tract Infection was identified in pregnant women from the public network of the city of Manaus. Among the microorganisms isolated in urine cultures, the highest prevalence was E. coli, followed by Streptococcus sp, Klebsiella pneumoniae and, Enterococcus faecalis. There was statistical significance between the etiologic agent and the variables month, year, and district zone for the prevalence of infection. The presence of Streptococcus predominated in pregnant women in the Southern District Zone and presents different epidemiological behavior from the other district zones, causing great concern, since it is one of the most important bacteria in the etiology of neonatal sepsis.