Authors : Kambale Kisuba; Paluku Maghulu; Kakule Mbaghendyabo

Volume/Issue : Volume 11 - 2026, Issue 2 - February

Google Scholar : https://tinyurl.com/y2ue8kbv

Scribd : https://tinyurl.com/bdf6vzxe

DOI : https://doi.org/10.38124/ijisrt/26feb272

Note : A published paper may take 4-5 working days from the publication date to appear in PlumX Metrics, Semantic Scholar, and ResearchGate.

Abstract : Urinary tract infection (UTI) among pregnant women can lead to adverse maternal and fetal outcomes. Human Immunodeficiency Virus (HIV) results in increased likelihood of opportunistic infections, including UTI. Antimicrobial resistance may contribute to persistence of UTI and, this may differ accordingly to age of the pregnancy, types of UTI and HIV clinical stages. Anatomical and physiological characteristics make UTIs particularly prevalent among women, especially those who are pregnant. These infections, whether they exhibit symptoms or not, pose significant risks to expecting mothers and their offspring. Furthermore, the risk of a UTI returning post-treatment adds a layer of complexity to its care. While there is a wide array of antimicrobial drugs availablefor treating infections, it is a matter of concern that antimicrobial resistance rapidly emerges followingthe approval of new drugs for clinical use. These, directly concerns the World Health Organization (WHO) to initiate a Global Action Plan in order to correctly address the problem of antimicrobial resistance in 2015. The current literature highlights the main bacteria found in UTIs, various family of antibiotic used in case of UTIs, reasons behind antibiotic resistance and the mechanisms of bacterial resistance.

Keywords : Literature, Antibiotic Resistance, UTI, Pregnancy, HIV.

References :

1. CDC. (2022). Suffering from a urinary tract infection? Centers for Disease Control and Prevention. https://www.cdc.gov/antibiotic-use/uti.html
2. Tessema, N. N., Ali, M. M., & Zenebe, M. H. (2020). Bacterial associated urinary tract infection, risk factors, and drug susceptibility profile among adult people living with HIV at Haswassa University Comprehensive Specialized Hospital, Hawassa, Southern Esthiopia. Scientific Reports, 10(1):1–9. https://doi.org/10.1038/s41598-020-67840-7
3. Kostakioti, M., Hultgren, S. J., & Hadjifrangiskou, M. (2012). Molecular blueprint of uropathogenic Escherichia coli virulence provides clues toward the development of anti- virulence therapeutics. Virulence, 3(7), 592–594. https://doi.org/10.4161/viru.22364
4. Jancel, T., & Dudas, V. (2002). Management of uncomplicated urinary tract infections. The Western Journal of Medicine, 176(1), 51–55. https://doi.org/10.1136/ewjm.176.1.51
5. Gupta, K., Hooton, T. M., Roberts, P. L., & Stamm, W. E. (2001). Patient-initiated treatment of uncomplicated recurrent urinary tract infections in young women. Annals of Internal Medicine, 135(1), 9–16. https://doi.org/10.7326/0003-4819-135-1-200107030-00004
6. Munita, J. M., & Arias, C. A. (2016). Mechanisms of Antibiotic Resistance. In Virulence Mechanisms of Bacterial Pathogens (pp. 481–511). John Wiley & Sons, Ltd. https://doi.org/10.1128/9781555819286.ch17
7. Sreeja M.K., Gowrishankar N.L., Adisha S., Divya K.C. (2017). Antibiotic Resistance-Reasons and the Most Common Resistant Pathogens – A Review. Research Journal of Pharmacy and Technology, 10(6), 1886–1890. https://doi.org/10.5958/0974-360X.2017.00331.6
8. Mahmoud, M. A., Aldhaeefi, M., Sheikh, A., & Aljadhey, H. (2018). Community pharmacists perspectives about reasons behind antibiotics dispensing without prescription: A qualitative study. BiomedicalResearch,           29(21). https://doi.org/10.4066/biomedicalresearch.29-18-1112
9. Chokshi, A., Sifri, Z., Cennimo, D., & Horng, H. (2019). Global Contributors to Antibiotic Resistance. Journal of Global Infectious Diseases, 11(1), 36–42. https://doi.org/10.4103/jgid.jgid_110_18
10. Wintersdorff Von, C. J. H., Penders, J., van Niekerk, J. M., Mills, N. D., Majumder, S., van Alphen, L. B., Savelkoul, P. H. M., & Wolffs, P. F. G. (2016). Dissemination of Antimicrobial Resistance in Microbial Ecosystems through Horizontal Gene Transfer. Frontiers in Microbiology, 7, 173. https://doi.org/10.3389/fmicb.2016.00173
11. Holmes, A. H., Moore, L. S. P., Sundsfjord, A., Steinbakk, M., Regmi, S., Karkey, A., Guerin, P. J., & Piddock, L. J. V. (2016). Understanding the mechanisms and drivers of antimicrobial resistance. Lancet (London, England), 387(10014), 176–187. https://doi.org/10.1016/S0140-6736(15)00473-0
12. Martínez, J. L., Coque, T. M., & Baquero, F. (2015). What is a resistance gene? Ranking risk in resistomes.     Nature    Reviews. Microbiology,      13(2),     116–123. https://doi.org/10.1038/nrmicro3399
13. Zhao, R., Feng, J., Liu, J., Fu, W., Li, X., & Li, B. (2019). Deciphering of microbial community and antibiotic resistance genes in activated sludge reactors under high selective pressure of different antibiotics. Water Research, 151, 388–402. https://doi.org/10.1016/j.watres.2018.12.034
14. Denning, D. W., Perlin, D. S., Muldoon, E. G., Colombo, A. L., Chakrabarti, A., Richardson, M. D., & Sorrell, T. C. (2017). Delivering on Antimicrobial Resistance Agenda Not Possible without Improving Fungal Diagnostic Capabilities. Emerging Infectious Diseases, 23(2), 177–183. https://doi.org/10.3201/eid2302.152042
15. Ventola, C. L. (2015). The antibiotic resistance crisis: Part 1: causes and threats. P & T: A Peer- Reviewed Journal for Formulary Management, 40(4), 277–283.
16. Marc, C., Vrignaud, B., Levieux, K., Robine, A., Guen, C. G.-L., & Launay, E. (2016). Inappropriate prescription of antibiotics in pediatric practice: Analysis of the prescriptions in primary care. Journal of Child Health Care: For Professionals Working with Children in the Hospital and Community, 20(4), 530–536. https://doi.org/10.1177/1367493516643421
17. Almagor, J., Temkin, E., Benenson, I., Fallach, N., Carmeli, Y., & DRIVE-AB consortium. (2018). The impact of antibiotic use on transmission of resistant bacteria in hospitals: Insights from an agent-based model. PloS One, 13(5), e0197111. https://doi.org/10.1371/journal.pone.0197111
18. Kapoor, G., Saigal, S., & Elongavan, A. (2017). Action and resistance mechanisms of antibiotics: A guide for clinicians. Journal of Anaesthesiology, Clinical Pharmacology, 33(3), 300–305. https://doi.org/10.4103/joacp.JOACP_349_15
19. Levin, P. A., & Angert, E. R. (2015). Small but Mighty: Cell Size and Bacteria. Cold Spring Harbor Perspectives in Biology, 7(7), a019216. https://doi.org/10.1101/cshperspect.a019216
20. Bush, K., & Bradford, P. A. (2016). β-Lactams and β-Lactamase Inhibitors: An Overview. Cold Spring Harbor    Perspectives    in            Medicine,              6(8),        a025247. https://doi.org/10.1101/cshperspect.a025247 CDC. 2013.
21. Prochnow-Mai, A., Clauson, M., Hong, J., & Murphy, A. B. (2016). Gram positive and Gram negative bacteria differ in their sensitivity to cold plasma. Scientific Reports, 6, 38610. https://doi.org/10.1038/srep38610
22. Page, M. G. P. (2012). Beta-Lactam Antibiotics. In T. J. Dougherty & M. J. Pucci (Eds.), Antibiotic Discovery and Development (pp. 79–117). Springer US. https://doi.org/10.1007/978-1- 4614-1400-1_3
23. Wang, F., Zhou, H., Olademehin, O. P., Kim, S. J., & Tao, P. (2018). Insights into Key Interactions between Vancomycin and Bacterial Cell Wall Structures. ACS Omega, 3(1), 37–45. https://doi.org/10.1021/acsomega.7b01483
24. Krause, K. M., Serio, A. W., Kane, T. R., & Connolly, L. E. (2016). Aminoglycosides: An Overview. Cold Spring Harbor Perspectives in Medicine, 6(6), a027029. https://doi.org/10.1101/cshperspect.a027029
25. Grossman, T. H. (2016). Tetracycline Antibiotics and Resistance. Cold Spring Harbor Perspectives in Medicine, 6(4), a025387. https://doi.org/10.1101/cshperspect.a025387
26. Parnham, M. J., Erakovic Haber, V., Giamarellos-Bourboulis, E. J., Perletti, G., Verleden, G. M., & Vos, R. (2014). Azithromycin: Mechanisms of action and their relevance for clinical applications. Pharmacology & Therapeutics, 143(2), 225–245. https://doi.org/10.1016/j.pharmthera.2014.03.003
27. Dinos, G. P., Athanassopoulos, C. M., Missiri, D. A., Giannopoulou, P. C., Vlachogiannis, I. A., Papadopoulos, G. E., Papaioannou, D., & Kalpaxis, D. L. (2016). Chloramphenicol Derivatives as Antibacterial and Anticancer Agents: Historic Problems and Current Solutions.          Antibiotics            (Basel,    Switzerland),        5(2),        20. https://doi.org/10.3390/antibiotics5020020
28. Papich M.G., & Linezolid. (2016). Saunders handbook of veterinary drugs. Docer.com.ar. https://docer.com.ar/doc/xcvvx1s
29. Bhattacharjee, M. (2016). Antibiotics That Inhibit Nucleic Acid Synthesis (pp. 109–128). https://doi.org/10.1007/978-3-319-40746-3_5
30. Saito, K., Warrier, T., Somersan-Karakaya, S., Kaminski, L., Mi, J., Jiang, X., Park, S., Shigyo, K., Gold, B., Roberts, J., Weber, E., Jacobs, W. R., & Nathan, C. F. (2017). Rifamycin action on RNA polymerase in antibiotic-tolerant Mycobacterium tuberculosis results in differentially detectable populations. Proceedings of the National Academy of Sciences of the United    States     of            America,                114(24), E4832–E4840. https://doi.org/10.1073/pnas.1705385114
31. Aldred, K. J., Kerns, R. J., & Osheroff, N. (2014). Mechanism of quinolone action and resistance. Biochemistry, 53(10), 1565–1574. https://doi.org/10.1021/bi5000564
32. Nainu F., A. Masyita, M.A. Bahar, M. Raihan, S.R. Prova, S. Mitra, & et al., (2021). Pharmaceutical Prospects of Bee Products: Special Focus on Anticancer, Antibacterial, Antiviral, and Antiparasitic   Properties—PubMed. https://pubmed.ncbi.nlm.nih.gov/34356743/
33. Fernández-Villa, D., Aguilar, M. R., & Rojo, L. (2019). Folic Acid Antagonists: Antimicrobial and Immunomodulating Mechanisms and Applications. International Journal of Molecular Sciences, 20(20), 4996. https://doi.org/10.3390/ijms20204996
34. Akter, T., Shahriar, A., Rahman, T., Mahmud, M. R., Alo, M., & Emran, T. B. (2020). Survival    Assessment of pathogenic bacteria with antibiotic resistance traits from fresh summer royal grape: In Vitro microbial challenge test. Journal of Microbiology, Biotechnology and Food Sciences, 10(3), 344–349. https://doi.org/10.15414/JMBFS.2020.10.3.344-349
35. Wróbel, A., Maliszewski, D., Baradyn, M., & Drozdowska, D. (2019). Trimethoprim: An Old Antibacterial Drug as a Template to Search for New Targets. Synthesis, Biological Activity and Molecular Modeling Study of Novel Trimethoprim Analogs. Molecules (Basel,    Switzerland),        25(1),     116. https://doi.org/10.3390/molecules25010116
36. Poirel, L., Jayol, A., & Nordmann, P. (2017). Polymyxins: Antibacterial Activity, Susceptibility Testing, and Resistance Mechanisms Encoded by Plasmids or Chromosomes. Clinical Microbiology Reviews, 30(2), 557–596. https://doi.org/10.1128/CMR.00064-16
37. Lerminiaux, N. A., & Cameron, A. D. S. (2019). Horizontal transfer of antibiotic resistance genes in    clinical   environments.    Canadian              Journal                  of            Microbiology,                      65(1),                     34–44.  https://doi.org/10.1139/cjm-2018-0275
38. Reygaert, W. C.  (2018). An overview of the antimicrobial resistance mechanisms of bacteria. AIMS Microbiology, 4(3), 482–501. https://doi.org/10.3934/microbiol.2018.3.482
39. Trimble, M. J., Mlynárčik, P., Kolář, M., & Hancock, R. E. W. (2016). Polymyxin: Alternative Mechanisms of Action and Resistance. Cold Spring Harbor Perspectives in Medicine, 6(10), a025288. https://doi.org/10.1101/cshperspect.a025288n
40. Culyba, M. J., Mo, C. Y., & Kohli, R. M. (2015). Targets for Combating the Evolution of Acquired Antibiotic Resistance.    Biochemistry,       54(23),   3573–3582. https://doi.org/10.1021/acs.biochem.5b00109
41. Hoffman, S. B. (2001). Mechanisms of Antibiotic Resistance. Compendium on Continuing Education for the Practising Veterinarian -North American Edition- 23(5):464-472
42. Blair, J. M. A., Webber, M. A., Baylay, A. J., Ogbolu, D. O., & Piddock, L. J. V. (2015). Molecular mechanisms of antibiotic resistance. Nature Reviews. Microbiology, 13(1), 42–51. https://doi.org/10.1038/nrmicro3380
43. Iredell, J., Brown, J., & Tagg, K. (2016). Antibiotic resistance in Enterobacteriaceae: Mechanisms and clinical implications. BMJ (Clinical Research Ed.), 352, h6420. https://doi.org/10.1136/bmj.h6420
44.  Pang, Z., Raudonis, R., Glick, B. R., Lin, T.-J., & Cheng, Z. (2019). Antibiotic resistance in Pseudomonas aeruginosa: Mechanisms and alternative therapeutic strategies. Biotechnology              Advances,              37(1),     177–192. https://doi.org/10.1016/j.biotechadv.2018.11.013
45. Hall, C. W., & Mah, T.-F. (2017). Molecular mechanisms of biofilm-based antibiotic resistance and tolerance in pathogenic bacteria. FEMS Microbiology Reviews, 41(3), 276–301. https://doi.org/10.1093/femsre/fux010
46. Lin, J., Nishino, K., Roberts, M. C., Tolmasky, M., Aminov, R. I., & Zhang, L. (2015). Mechanisms of antibiotic resistance. Frontiers in Microbiology, 6, 34. https://doi.org/10.3389/fmicb.2015.00034
47. Foster, T. J. (2017). Antibiotic resistance in Staphylococcus aureus. Current status and future prospects.           FEMS    Microbiology       Reviews, 41(3),     430–449. https://doi.org/10.1093/femsre/fux007
48. Peterson, E., & Kaur, P. (2018). Antibiotic Resistance Mechanisms in Bacteria: Relationships Between Resistance Determinants of Antibiotic Producers, Environmental Bacteria, and Clinical Pathogens. Frontiers in Microbiology, 9, 2928. https://doi.org/10.3389/fmicb.2018.02928
49. Gelband, H., & Laxminarayan, R. (2015). Tackling antimicrobial resistance at global and local scales. Trends in    Microbiology,      23(9),     524–526. ttps://doi.org/10.1016/j.tim.2015.06.005
50. Lentz GM. (2009). Urinary Tract Infections in Obstetrics and Gynecology | GLOWM. http://www.glowm.com/section-view/heading/Urinary Tract Infections in Obstetrics and Gynecology/item/118 Leopold, S. J., van Leth, F., Tarekegn, H., & Schultsz, C. (2014). Antimicrobial drug resistance among clinically relevant bacterial isolates in sub-Saharan Africa: A systematic review. The Journal of Antimicrobial Chemotherapy, 69(9), 2337–2353. https://doi.org/10.1093/jac/dku176
51. Tadesse, E., Teshome, M., Merid, Y., Kibret, B., & Shimelis, T. (2014). Asymptomatic urinary tract infection among pregnant women attending the antenatal clinic of Hawassa Referral Hospital, Southern Ethiopia. BMC Research Notes, 7, 155. https://doi.org/10.1186/1756- 0500-7-155
52. Manikandan S, Ganesapandian S, Singh M, & Kamaraguru A.K,. (2011). Emerging of Multidrug Resistance Human Pathogens from Urinary Tract Infections. https://doi.org/10.3923/crb.2011.9.15
53. Ugboma HAA, S. C. (2014). Prevalence and Antibiotic Susceptibility of Staphylococcus Aureus and Other Staphylococcal Infections in Pregnant Women Attending Antenatal Clinic in a Tertiary Hospital in Port Harcourt, Nigeria. Journal of Infectious diseases. and Therapy, 02(01). https://doi.org/10.4172/2332-0877.1000125
54. David, M. Z., & Daum, R. S. (2010). Community-associated methicillin-resistant Staphylococcus aureus: Epidemiology and clinical consequences of an emerging epidemic. Clinical Microbiology Reviews, 23(3), 616–687. https://doi.org/10.1128/CMR.00081-09
55. Otto, M. (2010). Looking toward basic science for potential drug discovery targets against community- associated MRSA. Medicinal Research Reviews, 30(1), 1-22. https://doi.org/10.1002/med.20160
56. Ilusanya, O., Adesetan, T., Egberongbe, H., & Otubushin, A. (2012). Asymptomatic Bacteriuria in Ante-Natal Patients Attending State Hopital, Ado-Ekiti, Ekiti State, Nigeria. Current Research Journal of Biological Sciences, 4.
57. Imade, P. E., Izekor, P. E., Eghafona, N. O., Enabulele, O. I., & Ophori, E. (2010). Asymptomatic bacteriuria among pregnant women. North American Journal of Medical Sciences, 2(6), 263–266. https://doi.org/10.4297/najms.2010.2263
58. Jimenez-Truque, N., Tedeschi, S., Saye, E. J., McKenna, B. D., Langdon, W., Wright, J. P., Alsentzer, A., Arnold, S., Saville, B. R., Wang, W., Thomsen, I., & Creech, C. B. (2012). Relationship between maternal and neonatal Staphylococcus aureus colonization. Pediatrics, 129(5), e1252-1259. https://doi.org/10.1542/peds.2011-2308
59. Top, K. A., Buet, A., Whittier, S., Ratner, A. J., & Saiman, L. (2012). Predictors of Staphylococcus aureus Rectovaginal Colonization in Pregnant Women and Risk for Maternal and Neonatal Infections. Journal of the Pediatric Infectious Diseases Society, 1(1), 7–15. https://doi.org/10.1093/jpids/pis001
60. Kurewa, N. E., Mapingure, M. P., Munjoma, M. W., Chirenje, M. Z., Rusakaniko, S., & Stray- Pedersen, B. (2010). The burden and risk factors of Sexually Transmitted Infections and Reproductive Tract Infections among pregnant women in Zimbabwe. BMC infectious Diseases, 10, 127. https://doi.org/10.1186/1471-2334-10-127
61. Shittu, A. O., Okon, K., Adesida, S., Oyedara, O., Witte, W., Strommenger, B., Layer, F., & NübelU. (2011). Antibiotic resistance and molecular epidemiology of Staphylococcus aureus in Nigeria. BMC Microbiology, 11, 92. https://doi.org/10.1186/1471-2180-11-92
62. Watkins, R. R., David, M. Z., & Salata, R. A. (2012). Current concepts on the virulence mechanisms of meticillin-resistant Staphylococcus aureus. Journal of Medical Microbiology, 61(Pt 9), 1179–1193. https://doi.org/10.1099/jmm.0.043513-0
63. Cheung, G. Y. C., & Otto, M. (2010). Understanding the significance of Staphylococcus epidermidis bacteremia in babies and children. Current Opinion in Infectious Diseases, 23(3), 208–216. https://doi.org/10.1097/QCO.0b013e328337fecb
64. Shahriar, A., Alo, M., Hossain, M. F., Emran, T. B., Uddin, M. Z., & Paul, A. (2019). Prevalence of Multi-Drug Resistance Traits in Probiotic Bacterial Species from Fermented Milk Products in Bangladesh. Microbiology Research Journal International, 1–10. https://doi.org/10.9734/mrji/2019/v29i230161