Bacterial profile, antibacterial susceptibility pattern and associated factors among women attending antenatal and postnatal health service at University of Gondar teaching Hospital, Northwest Ethiopia.
Back ground: Bacterial infection is an important cause of maternal morbidity and mortality especially in resource limited countries including Ethiopia. The major bacterial infections include urinary tract infection, septicemia and endometritis. The rise of antibiotic resistance bacterial infection poses a big threat to this vulnerable population. However, studies are lacking in Ethiopia.
Objective: To assess bacterial profile, antibacterial susceptibility pattern and associated factors among mothers attending antenatal and postnatal care health service.
Methods: A cross-sectional study was conducted on 222 study participants at the University of Gondar teaching Hospital from January 1 to May 30, 2016. Clinical specimens such as urine, blood and cervical discharge culture and antimicrobial susceptibility tests were done following standard procedure. Data were entered and analyzed with SPSS version 20. Bivariate and multivariate logistic regression model were carried out.
Conclusion: Overall prevalence of bacterial infection was high. The isolated bacterial pathogens were resistant for commonly prescribed antimicrobial agents. This calls urgent need of screening bacterial infections of pregnant and following delivery women in antenatal and postnatal follow up.
Keywords: antibiotic susceptibility pattern, bacterial profile, associated factor
Gravett CA, Gravett MG, Martin ET, Bernson JD, Khan S, Boyle DS et al; Serious and life-threatening pregnancy-related infections: Opportunities to reduce the global burden; PLoS Med. 2012; 9(10): doi:10.1371/journal.pmed.1001324.
Dhar H, Al-Busaidi I, Rathi B, Nimre EA, Sachdeva V, Hamdi I.; A study of post-caesarean section wound infections in a regional referral hospital. Clinical and basic res. 2014; 14(2): 211-217.
Lorenzo M.; The journal of nutrition, postnatal development of intestinal microflora as influenced by infant nutrition;J Nutrition Italy. 2008; 138( 9):1791S-5S.
Neu J, Rushing J.; Cesarean versus vaginal delivery: Long term infant outcomes and the hygiene hypothesis; Clinical Perinatal. 2011; 38(2):321–31.
Alemu A, Moges F, Shiferaw Y, Tafess K, Kassu A, Anagaw B et al; Bacterial profile and drug susceptibility pattern of urinary tract infection in pregnant women at University of Gondar Teaching Hospital, Northwest Ethiopia. BMC Research Notes. 2012, 5:197.
Obiogbolu CH, Okonko IO, Anyamere CO, Adedeji AO, Akanbi AO, Ogun AA, et al; Incidence of urinary tract infections among pregnant women in Akwa metropolis, southeastern Nigeria; Scientific Research and Essay. 2009; 4 (8):820-824.
Sriskandan S.; In infectious diseases, national centre for infection prevention and management, department of infectious diseases & immunity, imperial college London, UK.;J R Coll Physicians Edinb.2011; 41: 339–46.
Seale AC, Mwaniki M, Newton CR, Berkley JA. Maternal and early onset neonatal bacterial sepsis: burden and strategies for prevention in sub-Saharan Africa; Lancet Infect Dis. 2009; 9(7): 428–438.
Van Dillen J, Zwart J, Schutte J, van Roosmalen J.; Maternal sepsis: epidemiology, etiology and outcome; CurrOpin Infect Dis. 2010; 23(3):249-54.
Mary T, Busowski LM, John D, Busowski, Akhter M. Puerperal Group A Streptococcal infection;Case Reports in Medicine; 2013; doi.org/10.1155/2013/751329USA.
Glazener MA, Macarthure C.; Postnatal morbidity, puerperal sepsis; 2001;3(4):179-83.
Gebremeskel TK, Mihret A, Tikue MD; Prevalence and antibiotic susceptibility pattern of streptococcus agalactiae among pregnant women at adigrat zonal hospital and adigrat health center, tigray,Ethiopia;J gynecology and obstetrics. 2015;3(2):29-35.
Rimawi BH; Infectious Comorbidities Encountered in Obstetrics and Neonatology: Intraamniotic infections; OMICS Group eBooks. 2014: www.esciencecentral.org/ebooks.
Trabert B, Misra DP; Risk factors for bacterial vaginosis during pregnancy among African-American women; Am J Obstet Gynecol. 2007; 197(5): 477.
Gelband H, Delahoy M.; Policies to address antibiotic resistance in low- and middle-income countries; center for disease dynamics, economics& policy. 2014:1-36.
Mach KE, Baron EJ, Shih M, Gau V, Wong PK, Liao JC et al; A biosensor platform for rapid antimicrobial susceptibility testing directly from clinical samples, university of arizona. Tucson, Arizona; J urol. 2011; 185(1):148-53.
Royal College of Obstetricians and Gynecologists (RCOG): Bacterial sepsis following pregnancy. London (UK).;Green-top guideline. 2012; 21(64): 1-21.
Kasolo F, Yahaya AA, Ndihokubwayo JB, Impouma B, Oxenford CJ, Cognat S.; Guide for establishing laboratory-based surveillance for antimicrobial resistance; World Health Organization Regional Office for Africa. 2013:1-25.
Gilbert NM, O’Brien VP, Hultgren S, Macones G, Lewis WG, Lewis AL; Urinary Tract Infection as a preventable cause of pregnancy complications: opportunities, challenges, and a global call to action; Global Adv Health Med. 2013; 2(5):59-69.
Yudin MH, Money DM; Screening and management of bacterial vaginosis in pregnancy of Canada obstet’ gynaecol can; Ann Intern Med. 2008; 149(1):W20-4.
Conde-Agudelo A, Belizan JM, Lammers C.; Maternal-perinatal morbidity and mortality associated with adolescent pregnancy in Latin America: Cross-sectional study; Am J Obstet and gynecol. 2004; 192:342–349.
Mitt P, Lang K, Peri A, Maimets M.; Surgical-Site infections following cesarean section in an Estonian university hospital: Post discharge surveillance and analysis of risk factors; Infection control and hospital epidemiology 2005; 26(5):449-454.
Dolea C, Stein C.; Global burden of maternal sepsis in the year, World Health Organization, Geneva; Br Med Bull. 2003; 67 (1): 1-11.
Mason DM, Aronof KL; Postpartum Group A Streptococcus Sepsis and maternal immunology;Am J ReprodImmunol. 2012; 67(2):91–100.
Rivlin ME, Alderman E.; Postpartum endometritis and disseminated infection in both mother and neonate; Obstet Gynecol. 2012; 120(2):471-3.
Clinical and Laboratory Standards Institute. Performance standards for antimicrobial susceptibility testing: twenty-fourth informational supplement M100-S24. CLSI, Wayne, PA, USA, 2016.
Mengistie Z, Woldeamanuel Y, Asrat D, Adera A.; Prevalence of bacterial vaginosis among pregnant women attending antenatal care in TikurAnbessa University Hospital, Addis Ababa, Ethiopia. BMC Research Notes. 2014; 7:822.
Oud L.; Pregnancy-Associated Severe Sepsis: Contemporary State and Future Challenges; Infectious Diseases and Therapy. 2014; 3 (2):175-189.
Ahmed MI, Babiker AR; Puerperal sepsis in a rural hospital in sudan, susceptibility to antibiotics;Mat Soc Med. 2013; 25(1): 19-22.
Imade PE, Izekor PE, Eghafona NO, Enabulele OI, Ophori E.; Asymptomatic bacteriuria among pregnant women; North American J. Medical Sciences. 2010; 2(6): 263.
SamagaMP. Bacteriological Profile of Urinary Tract Infections in Pregnant Women; Indian J Microbiol Res. 2016; 3(1):17-21.
Al-Badr A, Al-Shaikh A. Recurrent Urinary Tract Infections Management in Women. Sultan Qaboosunive med J,2013; 13(3): 359–367.
Ferede G, Gizachew Y, Wondimeneh Y, Sisay Z.; The Prevalence and antimicrobial susceptibility pattern of bacterial uropathogens isolated from pregnant women, of Gondar, Ethiopia;European J Experimental Biology. 2012;2 (5):1497-502.
Demilie T, Beyene G, Melaku S, Tsegaye W.; Urinary bacterial profile and antibiotic susceptibility pattern among pregnant women in northwest Ethiopia; Ethiop J Health Sci. 2012; 22(2):121-128.
Derese B, Kedir H, Teklemariam Z, Weldegebreal F, Balakrishnan S.; Bacterial profile of urinary tract infection and antimicrobial susceptibility pattern among pregnant women attending at Antenatal Clinic in DilChora Referral Hospital, Dire Dawa, Eastern Ethiopia; Therapeutics and Clinical Risk Management 2016; 12:251–260.
Masinde A, Gumodoka B, Kilonzo A, Mshana S E; Prevalence of urinary tract infection among pregnant women at Bugando Medical Centre, Mwanza, Tanzania; Tanzania J. Health Research. 2009; 11(3): 154-161.
Gupta A, Garg P, Nigam S.; Bacterial Vaginosis in Pregnancy (<28 weeks and its effect on pregnancy outcome: A study from a western up city; Indian J Clinical Practice. 2013; 23 (11):740-744.ed
Parveen K, Momen A, Ara Begum A, Begum M.; Prevalence Of Urinary Tract Infection During Pregnancy; J. Dhaka National Med. Coll. Hos. 2011; 17 (02): 8-12.
Asrat D, Amanuel YW. Prevalence and antibiotic susceptibility pattern of bacterial isolates from blood culture in TikurAnbassa Hospital, Addis Ababa, Ethiopia. Ethiop Med J. 2001, 39(2):97-104.
Tizazu Z, SubbaramKannan, Daniel Yilma, Beyene G. Invasive bacterial pathogens and their antibiotic susceptibility patterns in Jimma University Specialized Hospital, Jimma, and Southwest Ethiopia. Ethiop J Health Sci. 2011;21(1): 1-8.
Gebreyesus A, Negash L, Aregawi S, Asmelash T, Luel A,Dejenie Tet al. Bacteriological profile and drug susceptibility pattern of blood culture isolates among febrile patients in Mekele hospital,Northern Ethiopia. springer plus 2015;4:314
Ali J, Kebede Y: Frequency of isolation and antimicrobial susceptibility pattern of bacterial isolation from blood culture in Gondar UniversityHospital. Ethio Med J 2008, 46(2):155–161.
Taffa N, Bjune G , Sundby J , Gaustad P, Alsterom A. Prevalence of Gonococcal and Chlamydial Infections and SexualRisk Behavior Among Youth in Addis Ababa, Ethiopia. Sexually transmitted disease 2002,29:12
Tibebu M,Shibabaw A, Medhin G, Kassu A.Neisseria gonorrhoeae non-susceptible to cephalosporins and quinolones in Northwest Ethiopia. BMC infectious disease, 2013;13:415
Hailemariam M, Abebe T, Mihret A, Lambiyo T.; Prevalence of Neisseria Gonorrhea and Their Antimicrobial Susceptibility Patterns Among Symptomatic Women Attending Gynecology Outpatient Department in Hawassa Referral Hospital, Hawassa, Ethiopia. Ethiop J Health Sci. 2013; 23(1): 10–18.
Ali S, Sewunet T, Sahlemaria Z, Kibru G. Neisseria gonorrhea among suspects of sexually transmitted infection in Gambella hospital Ethiopia: Risk factors and drug resistance.BMC research note2016;9:439
Moges B, Yismaw G, Kassu A, Megabiaw B, Alemu S,Amare B et al; Sexually transmitted infections based on the syndromic approach in Gondar town, northwest Ethiopia: a retrospective study; BMC Public Health. 2013; 13: 143.
Vaijanathrao CY, Nalini YL, Reddy CM. Antibiotic Sensitivity Pattern of Uropathogens: A Comparative Study between Symptomatic and Asymptomatic Bacteriuria in Pregnant Women;Int.J.Curr.Microbiol.App.Sci. 2015; 4(6): 689-695.
Bager P, Simonsen J, Ethelberg S, Frisch M. Cesarean Delivery and Risk of Intestinal Bacterial infection, C-Section and Intestinal Infection, Denmark; JID. 2010; 201 (15):898-902.
Dagnew M, Yismaw G, Gizachew M, Gadisa A, Abebe T, Tadesse T et al. Bacterial profile and antimicrobial susceptibility pattern in septicemia suspected patients attending Gondar University Hospital, NorthwestEthiopia. BMC Res Notes 2013; 6:283
Mpogoro FJ, Mshana SE, Mirambo MM, Kidenya BR, Gumodoka B, Imirzalioglu C.; Incidence and predictors of surgical site infections following caesarean sections at Bugando Medical Centre, Mwanza, Tanzania.Antimicrobial Resistance and Infection Contro. 2014; 3:25.
Jalali M, Shamsi M, Roozbehani N, Kabir K. Prevalence of Urinary Tract Infection and Some Factors Affected in Pregnant Women in Iran Karaj City Middle East; J of Scientific Research. 2014; 20 (7): 781-785.
Shamna M S, KalaichelvanVK, FazilMarickar YM, Deepu S.Cesarean Section and Prophylactic Antibiotics; IOSR Journal of Pharmacy and Biological Sciences.2014; 9 (2): 51-54.
Pokharel MS; Study on antibiotics sensitivity pattern of bacterial flora in cases of pre-labour rupture of membrane: Dissertation Kathmandu, Nepal: Tribhuvan University; 2004: 108.
Kankuriesko E, Kurkitatio T, Carison T, Esmaa HM; Incidence, treatment and outcome of peripartum sepsis; ActaObstetGynecol Scan. 2003; 82(8); 730-735.
Walker CK, Sweet RL; Gonorrhea infection in women: prevalence, effects, screening, and management; Int J Womens Health. 2011; 3: 197–206.
Komolafe AO, Adegoke AA. Incidence of bacterial septicemia in life Metropolis, Nigeria. Malaysian J Microbio 2008; 4(2): 51-61.
Diebold K E.; "Risk factors for wound complications following cesarean delivery." University of Iowa. 2014: 1-60.