背景:鉴于怀孕期间的生理变化,孕妇可能会发生复发性尿路感染(UTI)和肾盂肾炎,这可能会导致不良的产科结果,包括早产和低出生体重先兆子痫。然而,拉丁美洲孕妇UTI患病率和细菌谱的数据仍然很少,有必要进行本系统审查以解决这一问题。
方法:为了确定截至2022年9月发表的符合条件的观察性研究,在Medline/PubMed中系统地搜索了关键词,科克伦图书馆,Embase,WebofScience,以及Bireme/Lilacs电子数据库和GoogleScholar。采用荟萃分析的系统评价遵循系统评价和荟萃分析指南的首选报告项目。并根据《加强流行病学观察研究报告指南》对研究质量进行分类。荟萃分析采用随机效应方法,在R软件中进行双反正弦变换。
结果:数据库和手动搜索确定了253,550篇引文,直到2022年9月为止。在确定的引文中,67符合纳入标准,被纳入系统评价,对应于来自9个拉丁美洲国家的111,249名孕妇的样本。在拉丁美洲孕妇中,无症状菌尿的患病率,较低的UTI,和肾盂肾炎估计为18.45%(95%置信区间[CI]:15.45-21.53),7.54%(95%CI:4.76-10.87),和2.34%(95%CI:0.68-4.85),分别。还发现了一些区域差异。在纳入的研究中,大肠杆菌(70%)被确定为最常见的细菌种类,其次是克雷伯菌。(6.8%)。
结论:拉丁美洲的孕妇的菌尿患病率较高,UTI,和肾盂肾炎比孕妇全球。这种情况加强了在早期产前护理期间使用尿培养进行普遍筛查以确保改善结果的重要性。未来的调查应评估从拉丁美洲孕妇中分离出的尿路病原体的微生物敏感性。
背景:这项研究在PROSPERO注册(编号:CRD42020212601)。
BACKGROUND: Given the physiological changes during pregnancy, pregnant women are likely to develop recurrent urinary tract infections (UTIs) and
pyelonephritis, which may result in adverse obstetric outcomes, including prematurity and low birth weight preeclampsia. However, data on UTI prevalence and bacterial profile in Latin American pregnant women remain scarce, necessitating the present systematic
review to address this issue.
METHODS: To identify eligible observational studies published up to September 2022, keywords were systematically searched in Medline/PubMed, Cochrane Library, Embase, Web of Science, and Bireme/Lilacs electronic databases and Google Scholar. The systematic
review with meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, and the quality of studies was classified according to the Strengthening the Reporting of Observational Studies in Epidemiology guidelines. The meta-analysis employed a random-effects method with double-arcsine transformation in the R software.
RESULTS: Database and manual searches identified 253,550 citations published until September 2022. Among the identified citations, 67 met the inclusion criteria and were included in the systematic
review, corresponding to a sample of 111,249 pregnant women from nine Latin American countries. Among Latin American pregnant women, the prevalence rates of asymptomatic bacteriuria, lower UTI, and
pyelonephritis were estimated at 18.45% (95% confidence interval [CI]: 15.45-21.53), 7.54% (95% CI: 4.76-10.87), and 2.34% (95% CI: 0.68-4.85), respectively. Some regional differences were also detected. Among the included studies, Escherichia coli (70%) was identified as the most frequently isolated bacterial species, followed by Klebsiella sp. (6.8%).
CONCLUSIONS: Pregnant women in Latin America exhibit a higher prevalence of bacteriuria, UTI, and pyelonephritis than pregnant women globally. This scenario reinforces the importance of universal screening with urine culture during early prenatal care to ensure improved outcomes. Future investigations should assess the microbial susceptibility profiles of uropathogens isolated from pregnant women in Latin America.
BACKGROUND: This research was registered at PROSPERO (No. CRD42020212601).