Recurrent Urinary Tract Infections in Pregnancy: Microbiological Patterns and Associated Inflammatory Markers in Northern Sudan

Abstract

Background: Recurrent urinary tract infections (rUTIs) represent a significant clinical challenge during pregnancy, potentially leading to serious maternal and fetal complications. This study aimed to investigate the microbiological patterns and associated hematological and biochemical changes in pregnant women with rUTIs in Northern Sudan.
Methods: A cross-sectional study was conducted among 100 pregnant women diagnosed with recurrent UTIs attending antenatal care at Aldabah Hospital, Northern State, Sudan. Structured questionnaires were used to collect demographic and obstetric data. Urine samples were processed using standard microbiological techniques including culture on CLED and MacConkey agar media, Gram staining, and biochemical identification tests. Laboratory investigations included C-reactive protein (CRP), serum creatinine, and white blood cell (WBC) count determinations.
Results: The majority of participants (57%) were aged 14–27 years, with 49% in the third trimester of pregnancy. Escherichia coli was the predominant organism, isolated in 8% of positive cultures, followed by Enterococcus faecalis (7%) and Staphylococcus saprophyticus (5%). A significant association was found between the timing of first UTI onset and culture results (p=0.029). C-reactive protein was elevated in 41% of participants, indicating systemic inflammatory response. Hematological parameters showed no statistically significant differences according to infection onset timing.
Conclusion: Recurrent UTIs in pregnancy predominantly affect younger women and are most common in the third trimester. Escherichia coli remains the principal causative agent. Elevated CRP in a significant proportion suggests active inflammation. These findings emphasize the importance of routine antenatal screening and culture-guided antimicrobial therapy to prevent maternal and fetal complications.