الفهرس 
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Abstract
Summary
Urinary Tract Infections (UTI) are mostly occurring in the presence and growing of microorganisms in the urinary tract, affecting all age groups especially in pregnancy ( Ranjan et al., 2017).
The objective of this study is to detect the bacterial causes of urinary tract infection in pregnant women, the detection of the antibiotic susceptibility pattern of the isolated organisms and the molecular detection of pyelonephritis associated pilus (pap) encoding operon gene in associated E coli strains by PCR.
A cross sectional study was conducted on 150 pregnant women presented by symptoms of UTI attending antenatal care of Outpatient Clinic of Benha University hospital aged from 16-36 years old during the period from (2015 to 2016).
The dipstick strip test of the studied samples showed that, (13.3%) had protein +1 and (1.3% ) were +2, (2.0%) had glucose +1 and (8.0%) had nitrite +1 , (4.7 %) had blood +1. While all patients were negative to bilirubin, urobilinogen and ketone bodies.
The microscopic examination of the studied group showed that ,110 (73.3 % ) had pus cells >10, (16.7% ) had red cells >3 and (13.3% ) had uric acid and (13.3 % ) had Ca oxalate while only (3.3 %) had both of uric acid and Ca oxalate and only (4.7 % ) had yeast cells. There were no parasites or ova detected .
The result of this study revealed that, the percentage of UTI among the symptomatic pregnant women was (73.3% out of 150).
Regarding to socio-demographic data, it was observed that most cases with positive urine culture were ranged from 16-20 years old (39.1%) with a mean 23.8±5.2 , were from rural regions (76.4%), housewives (80.0%) with middle education (57.3%) and low social class (76.4%).
The education and social class were found to have a highly significant effect on UTI incidence and also residence has a significant effect.
According to the obstetric history, most of UTI patients didn’t have ANC (78.2%) and were primigravidia (58.2%) in the 1st trimester (42.7%).The ANC was found to have a highly significant effect on UTI incidence .
Regarding to the chronic diseases ,our study revealed that, (63.6%) of pregnant women with positive urine culture didn’t have a chronic diseases while (18.2%) had DM and (12.7%) had HTN while (5.5%) had both of them .The chronic diseases were found to have a significant effect on UTI incidence.
On the other hand, it was found that that (33.6%) of patients with positive culture had animea with a non-significant effect on UTI incidence .
The isolated organisms in our study were E. Coli (71.8%), Klebsiella pneumonia (18.2%), Pseudomonas aurginosa (7.3%), Proteus mirabilis (1.8%) and Enterococcus faecialis (0.9%).
All isolates showed a good sensitivity to amikacin, ciprofloxacin, gentamycin and cefotaxim except Enterococcus facialis which showed resistance to amikacin & ciprofloxacin and Pseudomonas which showed resistance to cefotaxime while all isolates showed resistance to erythromycin and ampicillin except Klebseilla pneumonia which showed sensitivity to ampicillin. The most sensitive antibiotic to E coli was amikacin (58.2%) followed by ciprofloxacin (48.1%).
In the concept of the detection of pap gene by PCR in the most resistant isolated E coli strains, it was found that 11 (55%) of them were positive while 9 (45.0% ) of them were negative.