A Multicenter Study on the Antimicrobial Resistance Pattern of Bacterial Uropathogens in Pregnant Women in Gambia

Background/Objectives: Urinary tract infections (UTIs) can predispose women to preeclampsia and prematurity, which are common causes of maternal and neonatal morbidity and mortality. In low-middle-income countries (LMICs), the capacity for screening and treating UTIs is limited. In sub-Saharan Africa, AMR surveillance data are scarce, especially in vulnerable populations such as pregnant women. The aim of this study was to determine the prevalence and antimicrobial resistance patterns of community-acquired urinary tract infections among pregnant women attending the antenatal clinics of three hospitals in Gambia. Methods: This was a hospital-based, cross-sectional, multicenter study conducted between November 2022 and January 2023. Patient information was obtained via a pre-tested questionnaire. The urine samples were analyzed via Gram staining and biochemical tests to determine the causative organisms. We also used antibiotic sensitivity testing to identify resistance patterns. The data collected were analyzed via SPSS version 20 and tested for associations at a significance level of p ≤ 0.05. Results: The prevalence of significant bacteriuria was 5% (n=100). Escherichia coli (40%) and Staphylococcus aureus (40%) were the most common uropathogens. The prevalence of resistance was found for trimethoprim/sulfamethoxazole and ampicillin, and multi-drug resistance was detected in only one isolate (Citrobacter freundii). Conclusion: This study revealed bacterial isolates with prevalent resistance to commonly prescribed drugs for community-acquired UTIs in pregnant women and suggested alternatives such as ceftriaxone, nitrofurantoin, erythromycin, and nalidixic acid as empirical treatment options. We recommend consistent health to combat drug resistance caused by inappropriate antibiotic use.