Diagnóstico y tratamiento de la infección de vías urinarias en el embarazo

Abstract

Introduction: Urinary Tract Infection (UTI) includes Asymptomatic Bacteriuria (ASB), acute cystitis and Acute Pyelonephritis (ANP). The main pathogen identified is Escherichia coli. In the world, its prevalence has been around 4% - 47%; in Ecuador it represents the fifth cause of hospital discharges in women. Objective: To investigate the current diagnosis and treatment of urinary tract infection in pregnancy, by reviewing the scientific literature of the last 5 years. Methodology: This is a descriptive-retrospective study, carried out by reviewing the scientific literature available from the last 5 years in databases such as PubMed, Elsevier and Google Scholar. Conclusion: The diagnosis of BA is made with a urine culture; in cystitis its diagnosis is based on clinical findings and urine culture or nitrite dipstick, leukocyte esterase test and urine sediments. Antibiotic therapy is recommended for 4 to 7 days. Regarding PNA, the diagnosis is based on clinical findings, urinalysis and blood count. In addition, urine culture and serum chemistry that include renal function must be requested; a biomarker (sST2) is being studied as a predictor of sepsis. Antibiotic therapy should not be delayed, with a 10 to 14 days course is suggested, starting intravenously and after 48 hours of apyrexia changing to oral route. It is recommended to repeat the urine culture after completing treatment and monthly in order to avoid recurrent PNA