Urology>>>>>Urinary Tract Infections (UTI)
Question 4#

Concerning UTI in pregnancy all the following are true, EXCEPT:

a. Asymptomatic bacteriuria detected should be eradicated with antibiotics
b. Women should not be screened for bacteriuria in the first trimester of pregnancy
c. Two consecutive specimens >105 cfu/mL of the same bacteria is defined as significant bacteriuria
d. Avoid trimethoprim in the first trimester
e. Avoid sulfamethoxazole in the third trimester

Correct Answer is B

Comment:

Answer B

Pregnancy does not alter the diagnostic criteria; therefore, in an asymptomatic pregnant woman, bacteriuria is considered significant if two consecutive voided urine specimens grow >105 cfu/mL of the same bacterial species on quantitative culture; or a single catheterised specimen grows >105 cfu/mL of a uropathogen.

Pregnant women should be screened for bacteriuria during the first trimester. Asymptomatic bacteriuria detected in pregnancy should be eradicated with antimicrobial therapy, with a standard short course. Trimethoprim is a dihydrofolate reductase inhibitor preventing DNA replication. Sulfamethoxazole inhibits bacterial use of para-aminobenzoic acid (PABA) for synthesis of folic acid, needed in DNA synthesis.