Antimicrobial Resistance Patterns of Uropathogens Isolated from Urine Cultures in Pregnant Women with Urinary Tract Infections in Peru: A Systematic Review of Studies Published Between 2015 and 2025

Urinary tract infections (UTIs) are among the most common infectious complications during pregnancy, and their empirical treatment has been increasingly challenged by antimicrobial resistance. In Peru, systematic surveillance of antimicrobial susceptibility patterns in pregnant women remains limited, hindering timely and safe clinical management. This systematic review, based on studies published between 2015 and 2025, analyzes resistance patterns of uropathogens in pregnant women, with a focus on the Peruvian context. Escherichia coli was the predominant pathogen, displaying high resistance to ampicillin, trimethoprim-sulfamethoxazole, and first-generation cephalosporins. Nitrofurantoin and fosfomycin remained effective treatment options in most reports. These findings underscore the urgent need to strengthen microbiological surveillance, promote rational antibiotic use, and establish updated clinical guidelines, particularly at the primary care level in Peru. This study recommends strengthening the program through: pre-participation training for students, collaboration with local education offices, and the use of digital technology to support learning. With optimal implementation, the Teaching Assistant Program not only contributes to educational equity but also prepares students to become competent and character-driven future leaders.