Prevalence, Antimicrobial Susceptibility Profile, and the Associated Risk Factors of Uropathogenic E. coli among Pregnant Women in Zakho City, Kurdistan Region, Iraq

Background: Escherichia coli (E. coli) are known to be a major cause of uropathogen among women globally. Urinary tract infection in pregnant women continues to pose clinical problems, which is a big burden for physicians. The emergence of antibiotic resistance to E. coli is inevitable and one of the critical health-associated problems. The present study aimed to determine the E. coli isolates, risk factors, and antibiotic resistance profile of the UTI among pregnant women. Methods: We conducted this cross-sectional study on pregnant women who attended maternity hospital in Zakho City, Kurdistan Region, Iraq. From October 2020 to January 2021, 196 subjects were recruited in the present experiment. Uropathogenic E. coli were detected from mid-stream urine of the participants. Subsequently, we performed antibiotic sensitivity test using microbiological standard tests. Through the use of designed questionnaires, the required data were collected, processed, and analysed via the Fisher’s exact test and Chi-square. Results: Out of a total of 196 subjects, 34 (17.34%) were culture positive for E. coli infection among pregnant women. A high rate of infection was detected in the age group of between 25-34 years (21.6%). Additionally, the highest rate of E. coli belonged to illiterate people (19.4%), followed by those with higher education (18.9%). The assessment of the risk factors associated with E. coli indicated that diabetes (P=0.028), a history of UTI infection (P=0.049), and the presence of symptoms during infection (P=0.001) were statistically significantly different. The antibiotics sensitivity profile in urine samples of pregnant women showed that E. coli were extremely sensitive to Nitrofurantoin (82.4%), Meropenem (79.4%), and around 67.6% for both Amikacin and Ciprofloxacin. Conclusion: The prevalence rate of E. coli infection is quite lower among pregnant women compared to that in non-pregnant ones. The major risk factors associated with E. coli during pregnancy were diabetes mellitus, a history of UTI, and the presence of symptoms during infection. E. coli isolated from urine samples seem to be different concerning antibiotic sensitivity pattern. During their regular follow-up, pregnant women should also be examined for major risk factors and antibiotic susceptibility.