تقييم التأثير المضاد للمركب النانوي الاخضر على البكتيريا المسببة لإلتهابات المسالك البولية لدى النساء الحوامل والمجهضات في محافظة كربلاء

Evaluation of the antibacterial effect of green nanocomposite on bacteria causing urinary tract infections in pregnant women and abortion women in Kerbala Province

The current study aimed to isolate and diagnose the bacteria that cause urinary tract infections in pregnant women and cause recurrent abortion, study the risk factors that help increase infection rates, estimate the resistance of the isolated bacterial species, and evaluate the inhibitory effect of the nanocomposite prepared using green methods from fenugreek seeds and TGF/Nps from fenugreek extract. Trigonella foenum-graecum (TFG) before and after loading the antibiotic Ampiciliin into Escherichia coli and Staphylococcus aureus bacteria, the most common among the total types of bacteria isolated from pregnant women and aborted women with urinary tract infections.
The current study included collecting 130 urine samples from women attending Al-Hindiya General Hospital, Obstetrics and Gynecology Hospital, Imam Hassan Hospital, and some specialized clinics in the Holy Karbala Province. Their ages ranged between (19-38) years. The samples were collected during a period of 5 months from (September 2023) Until (January 2024). Samples and data were collected using a questionnaire after obtaining their consent. 30 samples were excluded due to incomplete evidence, as well as the overlap of infections and infection with other diseases in pregnant and aborted women with urinary tract infections. The study included 100 samples. The distribution rates for women’s samples were 50 (50%) samples from pregnant women, of which 29 (29%) were distributed. Pregnancy without a urinary tract infection (Negative Urinary tract infection), as well as 21 (21%) pregnancies infected with a urinary tract infection (Positive Urinary tract infection), and the study sample also included aborted women, 50 (50%) samples were distributed according to the percentage of infection (UTI). There were 17 (17%) abortion that did not have a urinary tract infection (Negative UTI), and 33 (33%) abortion had a urinary tract infection (Positive UTI).
The results of the studied risk factors also showed a relationship between the incidence of UTI and age, as the highest percentage of women with UTI was within the age group (20-24), followed by the age group (25-29) years. It also indicated a relationship of incidence. With UTI and an increase in the abortion rate, the highest group with an infection rate of 22% of the total study samples was the age group (20-24) years, followed by the age group (30-34) years with an infection rate of 16%. The length of pregnancy also had a significant effect (P≤0.05) on increasing the incidence of UTI, as the length of the period was directly proportional to the increase in the incidence of UTI. The highest incidence of infection was reached during a period of 7-9 months from the beginning of pregnancy, as it was recorded at 24% of the total In their samples, as for aborted women, the pregnancy duration was 1-3 months, the highest infection rate (UTI+ev) was 44%, which clearly indicates that women infected with (UTI+ev) are more likely to miscarry in the first months of bacterial infection compared to aborted women within this category. The non-infected category (UTI-ev), which recorded 18%.
The results showed that pregnant women who have had a number of pregnancies are more susceptible to UTI infection, and that geographical location has a significant impact at the level of probability (P≤0.05) in the distribution of UTI infection rates between the city and the countryside. It indicated that the increase in abortion due to UTI infection in urban women is higher. Compared with women in the countryside.
The results of the current study showed that women with (UTI+ev) in the first trimester of pregnancy had a higher rate of abortion, reaching 44% among aborted women, compared with the first trimester of aborted women without (UTI-ev), which had a rate of 10%, which indicates the presence of A relationship between infection with (UTI+ev) and an increase in the rate of abortion in the first trimester compared to the other two trimesters, which were recorded at (16.6)%, respectively.
The percentage of aborted women who had a previous abortion (twice) was higher, reaching 34% among the aborted women who had (UTI+ev), compared to those who did not have (UTI-ev), for whom the percentage was (20)%. This indicates that there is a significant relationship with a probability level (P≤0.05) between recurrent abortion and urinary tract infection (UTI+ev), and the results of the study recorded that the absence or disappearance of symptoms (ABU) asymptomatic bacteriuria increases the risk of urinary tract infection among those with It helps in its progression to abortion.
The study found that the highest percentage of bacteria isolated in pregnant women with (UTI+ev) was E.coli, while the highest percentage of isolated bacteria was S. aureus in aborted women, followed by E.coli bacteria. The highest percentage of bacteria isolated was within the age group ( Under 29 years of age) the highest percentage of bacterial infections included E.coli bacteria (31.48%), then S. aureus bacteria (24.07%). Also, city women are more likely to be infected with bacteria that cause urinary tract infections, at a rate of 64.81%, compared to women living in rural areas, where they registered a rate of 35.19%. The most common species isolated causing urinary tract infections in the city were E. coli and then S. aureus.
The percentage of bacterial species isolated in the first trimester of pregnancy was S. aureus bacteria, followed by E. coli, compared to the second and third trimesters. From the results, it appears that repeated abortion are caused by infection with UTI resulting primarily from S. aureus bacteria, then E. coli, as the number of abortion is 3. At times, the most common bacterial isolates were S. aureus, followed by E. coli, K. pneumoniae, and then P. aeruginosa, respectively.
The results of preparing the nanocomposite using green methods from fenugreek seeds (TFG/Nps) indicated the success of the preparation process through examination of the infrared spectroscopy (FT-IR) and atomic force microscopy (AFM). The results indicated that the sizes were all within the nanoscale limits, as indicated by the results of Toxicity test: Hemolytic activity. The non-toxicity of the nuclear compound prepared from the fenugreek plant, as the toxicity rate reached 0.6% on human blood cells. The results of the sensitivity test showed that most of the isolates of E. coli and S. aureus bacteria were resistant to most antibiotics and sensitive to others. They were diagnosed using the VITEK 2 system test. The resistance of E. coli to the antibiotic (Ampicillin) was 66.66%, while the resistance of S. aureus was 66.66%. For the same antibody, the MIC concentration reached 100%.
The inhibitory effect on the growth of E. coli and S. aureus bacteria was studied by the TFG/NPs nanocomposite in its free form (T3) and the results were compared with the inhibitory ability of the free AMP antibiotic (T1) with what was recorded on the synergistic effect of the antibiotic after loading it. Treatment with the nanocomposite With the antibiotic TFG Nps/AMP (5T), it showed the highest rate of inhibition at the first and second concentration (C1, C2). These increases in the rate of inhibition were significant (0.05P≤), as the rate of inhibition for the two concentrations reached (11.66±2.581) mm compared to what was recorded in the treatment. The fourth (T4), which recorded the average concentrations of (5.16 ± 0.752) mm, related to treatment with the extract loaded with the antibiotic (TFG/AMP) to evaluate the inhibitory action of the isolated E. coli bacteria. The study recorded an increase in the diameter of the inhibition ring for the antibiotic (AMP) when loaded with the green nanocomposite. For the fenugreek plant TFG Nps/AMP (T5/C1-2), the increase was significant when compared with what was recorded in the results of treatment with the free antibiotic and the free nanocomposite at the two concentrations above. When treated with the first concentration (C1), the rate of inhibition of S. aureus reached (10.3 ± 1.15). ) mm and an inhibition rate of (14.6 ± 1.52) mm was recorded in the treatment with the second concentration (C2), and the results were also high when compared with what was recorded in the fourth treatment with its first and second concentrations (T4/C1-2).
The above results show that risk factors have a clear impact on the incidence of urinary tract infection and its development of abortion in pregnant women, and that the most dangerous bacteria due to their resistance are E. coli and S. aureus in pregnant women and abortion, and the prepared nanocomposite had a clear role in improving The therapeutic properties of an antibiotic with a minimum inhibitory concentration (MIC).