Sensitivity Pattern of Cefixime against Uropathogens Causing Urinary Tract Infection in Pregnant Women
DOI:
https://doi.org/10.37762/jgmds.13-3.865Keywords:
Urinary Tract Infection, Cefixime Sensitivity, Pregnancy, Uropathogens.Abstract
ABSTRACT
OBJECTIVES
This study aimed to determine the susceptibility pattern of cefixime against uropathogens causing urinary tract infections among pregnant women attending a tertiary care hospital in Peshawar, Pakistan.
METHODOLOGY
A descriptive cross-sectional study was conducted in the Department of Obstetrics and Gynaecology at Khyber Teaching Hospital, Peshawar, with approval from the Institutional Ethical Review Committee. The study was carried out over six months (June 30 2024, to December 31 2024). A total of 197 pregnant women with culture-confirmed UTI were enrolled through consecutive non-probability sampling. Midstream urine specimens were collected aseptically and processed for routine examination, culture, and antibiotic susceptibility testing. Culture and sensitivity testing were performed according to Clinical and Laboratory Standards Institute (CLSI) guidelines (the latest available hospital-level laboratory protocol). Cefixime susceptibility was reported as sensitive or resistant according to the standard zone interpretation used in the institutional microbiology laboratory. Data were analysed using SPSS version 20. Quantitative variables were summarised as means ± standard deviations. The chi-square test was used for subgroup analysis, and binary logistic regression was used to identify predictors of cefixime sensitivity. A p-value ≤ 0.05 was considered statistically significant. Odds ratios (OR) with 95% confidence intervals (CI) were reported.
RESULTS
Among 197 pregnant women with culture-confirmed UTIs, Escherichia coli was the most common uropathogen (83.8%). Overall, 36.5% of isolates were sensitive to cefixime, while 63.5% were resistant. Chi-square analysis demonstrated no significant association between cefixime sensitivity and age, BMI, education, residence, or uropathogen type. Binary logistic regression identified education as the only significant predictor of cefixime sensitivity (OR = 1.89, 95% CI: 1.16-3.08, p = 0.010).
CONCLUSION
A high level of cefixime resistance was observed among uropathogens, particularly E. coli. These findings highlight the importance of urine culture and susceptibility testing before antibiotic selection. However, broader multicenter studies with multiple antibiotics and additional clinical variables are needed before changing empirical treatment policies.
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