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Article Type

Original Study

Abstract

Background: Urinary tract infection (UTI) is a frequent health problem in women. Patients often present with significant pyuria, and sometimes with no bacterial growth. Objective: The purpose of this study was to investigate the correlations between demographic, clinical, and behavioral factors and urine culture findings and to analyze the antibiotic sensitivity patterns of the isolated uropathogens. Methods: A cross-sectional study was done among pregnant women presenting with elevated pus cells (> 20 cells/HPF). Data on demographic characteristics, pregnancy complications, and hygiene habits were analyzed. Urine culture and comparative antibiotic sensitivity tests were performed for the isolated pathogens (Escherichia coli and Staphylococcus aureus). Statistical analysis: Pearson Chi-square test (p < 0.05) was performed. Results: There was no statistically significant correlation between culture results and demographic features such as age, education, or BMI (p > 0.05). Cultural positivity was most common in the age group of 20–24 years, 42.0%. However, clinical complications were strongly associated with positive cultures (pyelonephritis 90.9%; p = 0.0001 and infectious fever 81.8%; p = 0.004), and these relationships were highly significant. Also important were behavioral factors, with wearing the same underwear for long periods (1–3 times/week) and having intercourse very frequently (> 2 times/week), both significantly associated with a positive culture (p = 0.0001 and p = 0.002, respectively). Microbiologically, S. aureus (n = 36) and E. coli (n = 52) were universally resistant to penicillin (97.2% and 98.1% respectively; p = 0.791). On the other hand, amikacin retained the highest sensitivity (94.4% vs. 84.6%), followed by ciprofloxacin, levofloxacin, and amoxicillin/clavulanic acid, while ceftriaxone showed a slight decrease to moderate sensitivity (58.3% vs. 57.7%). Conclusion: Demographic parameters were poor predictors of culture outcome, while upper urinary tract complications and poor perineal hygiene were good predictors of active infection. Due to the widespread penicillin resistance and the growing resistance to third-generation cephalosporins (e.g., ceftriaxone), amikacin, fluoroquinolones, and amoxicillin/clavulanic acid remain the most dependable empirical treatment options.

Keywords

Pyuria, Antibiotic sensitivity, Pyelonephritis, Urinary tract infection, Hygiene practices

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