Increase in Drug Resistant UTIs: What Does This Mean for Pregnant Women?

Urinary tract infections (UTIs) are a relatively common ailment, affecting about 50-60% of women in their lifetimes (1), and in many cases are easily treatable. However, if not effectively treated, they can lead to a variety of dangerous complications, especially in certain high-risk groups.

One population particularly threatened by UTIs is pregnant women and their babies. Women in general are more susceptible to UTIs than men. This is because they have a shorter distance between the rectum and urethra (which makes it easier for bacteria to spread between the two) (2), and a shorter urethra (which makes it easier for bacteria to ascend into the bladder) (3). During pregnancy, hormonal and anatomical changes further increase susceptibility to UTIs (4). Pregnant woman

In addition to a higher likelihood of UTIs during pregnancy, there is also greater risk associated with these infections in pregnant women. UTIs can lead to dangerous pregnancy complications such as preeclampsia and premature birth, and can cause birth injuries. In some cases, birth injuries associated with mismanaged UTIs can cause the baby to die or develop a disability such as cerebral palsy (CP) (5). Therefore, it is critically important that medical professionals discuss these risks with their pregnant patients, provide proper prenatal testing, and promptly treat UTIs if they occur. Failure to do so may be medical malpractice. (If this happened to you and your baby was harmed, our birth injury law firm may be able to help.)

When treating UTIs in pregnant women (or indeed, in any patient) doctors must be aware that UTIs may be resistant to antibiotics. Antibiotic resistance in UTIs has been an issue for years, but is becoming an increasingly prevalent problem. 

UTIs and antibiotic resistance: trends over time

“Resistance to antibiotics has become one of the world’s most pressing health issues,” writes Matt Richtel, in a recent piece for the New York Times. “Overuse of the drugs in humans and livestock has caused germs to develop defenses to survive, rendering a growing number of medications ineffective in treating a wide range of illnesses a phenomenon that is playing out worldwide with UTIs.”

Research by the New York City Department of Health has shown that a third of uncomplicated UTIs stemming from Escherichia coli (E.coli) bacteria are resistant to Bactrim, one of the most commonly prescribed antibiotics for UTIs. Moreover, at least a fifth of these infections were resistant to five other common antibiotics

Often, E.coli is resistant not only to individual antibiotics, but rather to broad groups of drugs called beta-lactam antibiotics, which share one method of attacking pathogens. Therefore, this type of resistance can simultaneously eliminate multiple treatment options (2). 

What can be done?

In order to truly solve the issue of antibiotic resistance, health organizations worldwide will need to review their protocol for when they prescribe antibiotics, and in each scenario carefully weigh the risk of future resistance with the current need for antibiotic treatment. However, as Richtel notes, “…more immediately, a partial solution would be the development of quick, cheap diagnostic tools that would allow an instant urine culture so that a doctor could prescribe the right drug for UTIs.”

Along these lines, the New York City Department of Health recently developed a mobile app that allows medical professionals to quickly determine which drugs a strain of urinary tract infection is resistant to. 

Currently, lab results for UTIs take several days, and these tests can be expensive. Moreover, the potential dangers associated with untreated UTIs  – not to mention the irritating symptoms  –  often prompt doctors to prescribe an antibiotic before running a urine culture (2). 

Essentially, taking antibiotics increases an individual’s likelihood of developing drug-resistant bacteria, but antibiotic prescriptions may be necessary in order to treat UTIs. Because of this catch-22, UTI prevention is very important. This is especially true for people who are prone to recurrent UTIs, and for high-risk populations such as pregnant women. 

In some circumstances, antibiotics may be necessary even as a preventative measure (typically, a lower dose is given). However, there are a variety of other strategies that may lower the risk of UTIs. These include the following (please note that not all of these strategies have conclusive research to back them up, but preliminary studies suggest they may be effective):

  • Vaginal estrogen therapy
  • Increased water intake (this may decrease the risk by as much as 48%)
  • Dietary supplements/changes
  • Careful hygiene practices (especially shortly before and after sexual intercourse)
  • Avoidance of spermicidal jelly, vaginal douching, and other irritating substances

Click here to learn more about these and other strategies, and what research has been done on each (6). Please note that a doctor should also be consulted about which methods may be safe and effective, especially during pregnancy.

Medical organizations should also make it a priority to research methods of UTI prevention that don’t increase the risk of developing antibiotic resistance. This also means developing a deeper knowledge of the risk factors and causes of UTIs. For example, new research indicates that E.coli bacteria from poultry is often responsible for these infections (the bacteria must still spread from the rectum to the urethra, but the initial source of bacteria is chicken consumption). A CDC-funded project is now working to determine whether UTIs should be classified as a food-borne illness (2).

UTIs, pregnancy, and birth injury

During pregnancy, it is the responsibility of medical professionals to screen for UTIs and provide prompt treatment if one arises. In treating a pregnant patient, they must consider her own health as well as the health of the baby. 

If a doctor fails to treat a UTI, and this causes a neonatal infection or other birth injury, it is an act of medical malpractice. For more information on UTIs during pregnancy and birth injury law suits, please click here

About ABC Law Centers

ABC Law Centers was established to focus exclusively on birth injury cases. A “birth injury” is any type of harm to a baby that occurs just before, during, or after birth. This includes issues such as oxygen deprivation, infection, and trauma. While some children with birth injuries make a complete recovery, others develop disabilities such as cerebral palsy and epilepsy.

If a birth injury/subsequent disability could have been prevented with proper care, then it constitutes medical malpractice. Settlements from birth injury cases can cover the costs of lifelong treatment, care, and other crucial resources. 

If you believe you may have a birth injury case for your child, please contact us today to learn more. We are happy to talk to you free of any obligation or charge. In fact, clients pay nothing throughout the entire legal process unless we win. 

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Sources

  1. Al-Badr, A., & Al-Shaikh, G. (2013). Recurrent urinary tract infections management in women: a review. Sultan Qaboos University Medical Journal, 13(3), 359. 
  2. Richtel, M. (2019, July 13). Urinary Tract Infections Affect Millions. The Cures Are Faltering. Retrieved July 15, 2019, from https://www.nytimes.com/2019/07/13/health/urinary-infections-drug-resistant.html 
  3. Hisano, M., Bruschini, H., Nicodemo, A. C., & Srougi, M. (2012). Cranberries and lower urinary tract infection prevention. Clinics, 67(6), 661-668. 
  4. Johnson, E. K., Wolf, J. S., & Edward, K. (2017). Urinary tract infections in pregnancy: Medscape; 2016. 
  5. ABC Law Centers (n.d.). Urinary Tract Infections (UTI) & Bacterial Vaginosis (BV). Retrieved July 15, 2019, from https://www.abclawcenters.com/practice-areas/prenatal-birth-injuries/maternal-infections/urinary-tract-infections-and-bacterial-vaginosis/ 
  6. ABC Law Centers. (2018, September 13). Prevention of Urinary Tract Infections (UTIs). Retrieved July 15, 2019, from https://www.abclawcenters.com/blog/2018/07/12/prevention-of-urinary-tract-infections-utis/ 

 

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