Examination of broad-spectrum beta-lactamase-producing E. coli vaginal colonization and antibiotic resistance in pregnant women: A pilot study in Iran

Objectives: Urinary tract infection (UTI) is a common complication during pregnancy that can have severe consequences for both the mother and the fetus. ESBL-producing strains of E. coli present a significant challenge in terms of treatment during pregnancy. This study aims to identify pregnant women carrying beta-lactamase-producing E. coli and assess the antibiotic resistance patterns of these isolates. Methods: This cross-sectional study investigated the presence of broad-spectrum beta-lactamase-producing E. coli isolates in pregnant women attending medical centers affiliated with Kashan University of Medical Sciences. Vaginal colonization, associated complications, and antibiotic resistance profiles were assessed. The antibiogram test using the disc diffusion method was employed to determine colonization and antibiotic susceptibility, while PCR testing was used to detect genes associated with beta-lactamase production. Results: Among the 175 samples collected, 51 samples tested positive for E. coli, with 15 of these samples containing ESBL-producing isolates. A significant correlation was observed between the frequency distribution of E. coli isolates and factors such as age, history of urinary tract infections, body mass index, and previous abortions in pregnant women. Among the 15 ESBL-producing E. coli isolates, the blaSHV, blaTEM, and blaCTX-M resistance genes were detected in 12 (80%), 9 (60%), and 1 (6.66%) isolates, respectively. Conclusion: The prevalence of ESBL-producing E. coli in pregnant women underscores the urgent need for public health interventions to combat antibiotic resistance.