Author name:
امنة علي ناصر حسين
Supervisor name:
شيماء جاسم محيميد السلطاني
Key words:
- Urinary Tract Infections
- Interleukin 18receptor 1and interleukin 10for pregnancy
Abstract:
The urinary tract is a common infection location. Even asymptomatic urinary tract infection (UTI) during pregnancy increases maternal and newborn morbidity and mortality. This study included, blood and urine specimens were obtained from 120 pregnant individuals exhibiting signs and symptoms of urinary tract infections and 44 specimens of non-pregnant women utilized as control in immunological study. The collected specimens were obtained with ages ranging from 18 to 41 years, following clinical diagnosis by a consultant physician during the period (from September 2023 and June 2024) attended to women's and children's hospitals/Muthanna and a specialized health clinic for obstetrics and gynecology. The specimens were obtained from urinary tract infections (UTIs) using sterile cap containers for urine collection and Amie's transport swabs. The collected samples included urine for dipstick diagnosis and examination of urine sediment under a microscope. Additionally, serum samples were collected for the detection of certain immunological factors. At last, urine specimens were subsequently cultured in various types of media, including Blood agar, MacConkey agar, Columbia agar, chromogenic UTIs agar, chromogenic candida agar, Mannitol salt agar, and Eosin methylene blue. The cultures were then incubated under both aerobic and anaerobic conditions (using the candle jar method) at a temperature of 37 C for a period of 24 to 48 hours. The findings of the cultured media examination indicated that out of the (102) specimens, there was growth of both gram-positive and gram-negative bacteria. Additionally, (20) specimens showed growth of fungus. The identification of all isolates was conducted by morphological and biochemical tests, as well as the utilization of the VITEK 2 compact system. There was a total of 55 isolates of Gram-positive bacteria, accounting for 53.91% of the total. In contrast, there were 47 isolates of Gram-negative bacteria, making up 46.09% of the total. There were 20 fungal isolates with mixed growth, accounting for 19.6% of the total. The number of isolates that belongs to Escherichia coli 27(26.47%), Enterococcus faecalis 18 (17.64%), Staphylococcus aureus 22 (21.56%), Staphylococcus sciuri 1 (0.98%), Staphylococcus xylosus 1 (0.98%), Staphylococcus lugdunensis 1 (0.98%), Staphylococcus haemoiyticus 1 (0.98%), Staphylococcus hominis 2(1.96%), Staphylococcus epidermidis 3 (2.94%), Staphylococcus saprophyticus 5 (4.90%), Klebsiella pneumoniae 8 (7.84%), Pseudomonas aeruginosa 10 (9.80%), Proteus mirabilis 1 (0.98%),Enterobacter cloacae complex 1 (0.98%), Kocuria rhizophila 1 (0.98%), while fungal isolated Candida .albicans 19 ( 18.6%) and Candida glabrata 1(0.98%). The antibiotic susceptibility of the isolates was tested using the Kirby-Bauer method on a Muller-Hinton plate, also the Vitek-2 AST system was used to conduct susceptibility testing for antifungal drugs (AST). The antibiotic susceptibility data indicated that E. coli had a high level of sensitivity to various drugs, such as levofloxacin (85.2%), nitrofurantoin (74.1%), and ciprofloxacin (85.2%). Klebsiella pneumonia had a high sensitivity to a broad spectrum of medicines, such as levofloxacin, nitrofurantoin, and ciprofloxacin (100%). Enterococcus faecalis demonstrated high resistance to penicillin. The antifungal susceptibility test showed that Candida albicans exhibited 100% sensitivity to Caspofungin, Micafungin, and Flucytosine. In addition, C. albicans showed a sensitivity rate of 94.73% to amphotericin B, fluconazole, and voriconazole. Candida glabrata exhibited complete resistance (100%) to Caspofungin, Micafungin, Flucytosine, Amphotericin B, Fluconazole, and Voriconazole. The study presents the identification of C. reactive protein (CRP) by measuring the concentration of the protein in whole blood using the automated fluorescence immunoassay system AFIAS 6, which is an immunological test. Additionally, the levels of interleukin-18 receptor 1 (IL-18R1) and interleukin-10 (IL-10), which are immunological parameters, were measured in serum using the ELISA method. The C-reactive protein (CRP) level in whole blood was measured to be (10.2 ± 3.48 mg/L). The concentration of IL-10 in serum was found to be (55.5 ± 12.9 pg./ml), while the concentration of IL18R1 in serum was (24.5 ± 7.82 pg./ml). There were significant differences (p < 0.001) compared with control group. The concentration of C. reactive protein (CRP) had the greatest pregnant women who were infected with K. pneumonia, which was significantly higher than the usual range compared with other bacterial infection and control group. Interleukin10 (IL10) concentration level in pregnant women who were infected with E. coli and K. pneumoniae had the highest concentration of IL-10, followed by pregnant women infected with P. aeruginosa were significantly. On other hand, highest level of interleukin 18 receptor 1(IL-18R1) found in pregnant women infected with K. pneumoniae, followed by pregnant women infected with S. aureus and E. coli, while pregnant women infected with E. faecalis had the lowest level of IL-18R1
