Prevalence, etiological microorganisms and treatment susceptibility in urinary tract infections in pregnant women of Kohat Khyber Pakhtunkhwa

Authors

  • Heema Liaqat Memorial Hospital Kohat Pakistan
  • Syed Hasnain Ali Shah Khyber Medical University Peshawar Pakistan https://orcid.org/0000-0002-4595-0232
  • Tariq Mahfooz Khawaja Kabir Medical College Peshawar Pakistan https://orcid.org/0009-0003-3600-4206
  • Naimat Ullah Khan Khyber Medical University Peshawar Pakistan
  • Kausar Rehman Shinwari Liaqat Memorial Hospital Kohat Pakistan
  • Saif Ullah Khan Kabir Medical College Peshawar Pakistan

DOI:

https://doi.org/10.59736/IJP.23.03.979

Keywords:

Antimicrobial Resistance, Escherichia coli, Pregnancy, Risk Factors, Urinary Tract Infection

Abstract

Background: This study aimed to determine the frequency of urinary tract infection (UTI), identify the causative organisms, and assess the antibiotic sensitivity patterns among pregnant women in Kohat.

Methods: This cross sectional observational study enrolled 350 pregnant women attending Health Ways Hospital Kohat during December 2024 to April 2025. Midstream clean-catch urine samples were collected and cultured. Positive cultures were further analysed for antimicrobial susceptibility. Socio-demographic characteristics, hemoglobin levels, parity status, trimester of pregnancy, and education levels were also recorded. Data was analysed using SPSS version 22.0.

Results: Out of 350 pregnant women aged 18–42 years (mean age 29.84 ± 4.93), 48 (13.7%) were diagnosed with UTI based on positive urine culture. Most cases occurred in the 25–30 age groups. Multiparous women showed a higher prevalence of UTI. A greater proportion of UTI-positive women belonged to low socioeconomic backgrounds and had only primary or secondary education. UTI was more frequent in the third trimester. Escherichia coli (E. coli) were the most common isolated pathogen (45.8%), followed by Klebsiella pneumoniae (18.7%), Pseudomonas (12.5%), Staphylococcus aureus (10.4%), and Enterococcus (10.4%). Highest antibiotic sensitivity was observed for piperacillin-tazobactam (91.7%), meropenem (85.4%), nitrofurantoin (81.2%), and fosfomycin (79.1%). Moderate sensitivity was noted with cefixime, cefotaxime and amoxicillin/clavulanic acid, while high resistance was observed with ampicillin and ciprofloxacin.

Conclusion: A notable proportion of pregnant women in Kohat suffered from UTI, with E. coli being the predominant uropathogen. Piperacillin-tazobactum, meropenem, nitrofurantoin, and fosfomycin were the most effective antibiotics. Continuous screening, culture-based diagnosis, and local antibiotic guidelines are necessary to manage UTIs in pregnancy and prevent maternal-fetal complications.

Author Biographies

  • Heema, Liaqat Memorial Hospital Kohat Pakistan

    Assistant professor gynecology

  • Syed Hasnain Ali Shah, Khyber Medical University Peshawar Pakistan

    PhD Scholar Pharmacology

  • Tariq Mahfooz Khawaja, Kabir Medical College Peshawar Pakistan

    Assistant Professor Pharmacology

  • Naimat Ullah Khan, Khyber Medical University Peshawar Pakistan

    PhD Scholar Pharmacology

  • Kausar Rehman Shinwari, Liaqat Memorial Hospital Kohat Pakistan

    Medical Officer

  • Saif Ullah Khan, Kabir Medical College Peshawar Pakistan

    Associate Professor Pharmacology

References

Ansaldi Y, de Tejada Weber BM. Urinary tract infections in pregnancy. Clin Microbiol Infect. 2023;29(10):1249–53.

Pardeshi P. Prevalence of urinary tract infections and current scenario of antibiotic susceptibility pattern of bacteria causing UTI. Indian J Microbiol Res. 2018;5(3):334–8.

Mancuso G, Midiri A, Gerace E, Marra M, Zummo S, Biondo C. Urinary tract infections: the current scenario and future prospects. Pathogens. 2023;12(4):623.

Wanjiku A. The influence of trimesters on progesterone and Escherichia coli urinary tract infection in pregnant women attending Moi Teaching and Referral Hospital antenatal clinic [dissertation]. Eldoret: University of Eldoret; 2018.

Wong D, McCoy AM, Wilkins PA. Urinary tract disorders. In: Equine Neonatal Medicine. 2024. p. 684–704.

Bhargava K, Nath G, Bhargava A, Kumari R, Aseri G, Jain N. Bacterial profile and antibiotic susceptibility pattern of uropathogens causing urinary tract infection in the eastern part of Northern India. Front Microbiol. 2022;13:965053.

Shahzad M, Khan EM, Khan OQ, Tariq U, Sabahat A. Urinary tract infections: epidemiology, mechanisms of infection, and treatment. Pak J Med Health Sci. 2022;16(10):810–2.

Sah BK, Dahal P, Mallik SK, Paul AD, Mainali U, Shah C, et al. Uropathogens and their antimicrobial-resistant pattern among suspected urinary tract infection patients in eastern Nepal: a hospital inpatients-based study. SAGE Open Med. 2023;11:20503121231220821.

Bhugra A, Gachinmath S. Significant bacteriuria among requested repeat urine samples and its clinical correlation. Iran J Microbiol. 2021;13(5):592–8.

Gul A, Khan M. Antimicrobial susceptibility and resistance profiling of uropathogens to fosfomycin and ciprofloxacin in patients visiting tertiary care hospitals of Peshawar. Int J Pathol. 2019;17(3):105–11.

Adekanmbi AO, Akinlabi OC, Usidamen S, Olaposi AV, Olaniyan AB. High burden of ESBL-producing Klebsiella spp., Proteus mirabilis, Enterobacter cloacae and Pseudomonas aeruginosa in diagnosed cases of urinary tract infection in a Nigerian teaching hospital. Acta Microbiol Immunol Hung. 2022;69(4):305–16.

Association WM. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human participants. JAMA. 2025;333(1):71–4.

Humphries RM, Ambler J, Mitchell SL, Castanheira M, Dingle T, Hindler JA, et al. CLSI methods development and standardization working group best practices for evaluation of antimicrobial susceptibility tests. J Clin Microbiol. 2018;56(4):e01934–17.

Gul A, Khan M, Ali M, Shuaib SL, Sahar S. Catheter-associated urinary tract infection: characterization of bacterial pathogens and their antimicrobial susceptibility pattern at two major tertiary care hospitals. Int J Pathol. 2021;19(3):194–9.

Medina M, Castillo-Pino E. An introduction to the epidemiology and burden of urinary tract infections. Ther Adv Urol. 2019;11:1756287219832172.

Alanazi MQ, Alqahtani FY, Aleanizy FS. An evaluation of E. coli in urinary tract infection in the emergency department at KAMC in Riyadh, Saudi Arabia: a retrospective study. Ann Clin Microbiol Antimicrob. 2018;17(1):3.

Shaheen HM, Farahat TM, Hammad NE-H. Prevalence of urinary tract infection among pregnant women and possible risk factors. Menoufia Med J. 2016;29(4):1055–9.

Asmat U, Mumtaz MZ, Malik A. Rising prevalence of multidrug-resistant uropathogenic bacteria from urinary tract infections in pregnant women. J Taibah Univ Med Sci. 2021;16(1):102–11.

Aslam I, Sharif N, Manzoor U, Qureshi S, Azhar T, Bano S, et al. Urinary tract infection and associated risk factors among pregnant women at a tertiary care hospital. Prof Med J. 2024;31(11):1603–7.

Mohamed MS, Nassir NA. Prevalence of urinary tract infection and associated factors among pregnant women attending the obstetric clinic of Baghdad Teaching Hospital, 2023–2024. Iraqi J Community Med. 2025;38(1):68–74.

Mohapatra S, Panigrahy R, Tak V, JV S, KC S, Chaudhuri S, et al. Prevalence and resistance pattern of uropathogens from community settings of different regions: an experience from India. Access Microbiol. 2022;4(2):000321.

Das A, Banerjee T. Prevalence of urinary tract infections and susceptibility pattern of uropathogens in women of reproductive age group from North India. J Adv Med. 2015;4(1–2):5–9.

Abdulla AJ, Abdulla D. Prevalence of urinary tract infection and its related factors in a sample of school-age children from Baghdad, Iraq. Iraqi J Med Sci. 2022;20(3):145–51.

Abejew AA, Denboba AA, Mekonnen AG. Prevalence and antibiotic resistance pattern of urinary tract bacterial infections in Dessie area, North-East Ethiopia. BMC Res Notes. 2014;7(1):687.

Sajed AN, Batool U, Iram S, Yousaf NW, Asghar MN, Khan S, et al. Prevalence of urinary tract infections and their antibiotic sensitivity in a tertiary care hospital, Lahore. IOSR J Dent Med Sci. 2014;13(12):57–61.

Bazaid AS, Saeed A, Alrashidi A, Alrashidi A, Alshaghdali K, Hammam SA, et al. Antimicrobial surveillance for bacterial uropathogens in Ha’il, Saudi Arabia: a five-year multicenter retrospective study. Infect Drug Resist. 2021;14:1455–65.

Rahman F, Akhter H, Hasnat S, Begum N. Prevalence and antimicrobial sensitivity profile of uropathogens in a tertiary care hospital of Dhaka city. Bangladesh J Med Microbiol. 2020;14(2):3–11.

Downloads

Published

2025-09-29

Issue

Section

Original article

How to Cite

1.
Heema, Shah SHA, Khawaja TM, Khan NU, Shinwari KR, Khan SU. Prevalence, etiological microorganisms and treatment susceptibility in urinary tract infections in pregnant women of Kohat Khyber Pakhtunkhwa. Int J Pathol [Internet]. 2025 Sep. 29 [cited 2025 Oct. 8];23(3):174-81. Available from: https://jpathology.com/index.php/OJS/article/view/979