Bacterial profile, antibacterial susceptibility pattern and associated factors among women attending antenatal and post-natal health services at the University of Gondar Teaching Hospital, Northwest Ethiopia

Background: Bacterial infections are an important cause of maternal morbidity and mortality especially in re-source limited countries such as Ethiopia. The major bacterial infections include urinary tract infections, septice-mia and endometritis. Antibiotic resistant bacterial pathogens have become a growing problem worldwide and pose a serious threat to vulnerable populations, including mothers. However, studies which address the problem in the Ethiopian setting are scarce. Objective: To assess the bacterial profile, antibacterial susceptibility pattern and associated factors among mothers attending antenatal and postnatal care health services. Methods: A cross-sectional study was conducted on 222 study participants at the University of Gondar Teaching Hospital from January 1 to May 31, 2016. Clinical specimens such as urine, blood and cervical discharge specimens were collected from patients and antimicrobial susceptibility tests conducted following standard procedures. Data were entered and analyzed with SPSS version 20. Bivariate and multivariate logistic regression models were applied in data analysis. Results: Out of 222 specimens collected, 57(25.7%) bacterial species were isolated. The predominant bacterial isolates from urine culture were Escherichia coli (24/47; 51.1%) and Staphylococcus aureus (16/47;34%). From blood cultures, Staphylococcus aureus (2/8; 25%), Coagulase negative staphylococci (2/8;25%), Klebsiella pneumoniae (2/8;25%) and Streptococcus pyogenes 2/8(25%) were isolated. Neisseria gonorrheae (2/27;7.4%) was isolated from cervical discharge cultures. The majority of the isolates were resistant to amoxacillin and ampicillin but susceptible to ceftriaxone. Many multidrug resistant bacterial species were isolated. Being in the first trimester of pregnancy and having a history of diabetes mellitus were strongly associated with the presence of bacterial infections. Conclusion: The overall prevalence of bacterial infections was high with many being resistant to commonly pre-scribed antimicrobial agents. This calls for an urgent need to conduct screening of bacterial infectionsin both antenatal as well as postnatal women

Bacterial Profile, Antibacterial Resistance Pattern, and Associated Factors from Women Attending Postnatal Health Service at University of Gondar Teaching Hospital, Northwest Ethiopia.

INTRODUCTION: Surgical site infection is a vital cause of maternal mortality and morbidity, especially in resource-limited countries. The rise of antibiotic resistance bacterial infection poses a big threat to this vulnerable population. However, there is lack of studies around the study area. OBJECTIVE: The purpose of this study was to identify bacterial profile, antibacterial resistance pattern, and associated factors among mothers attending postnatal care health service. METHODS: Institutional based cross-sectional study was conducted on 107 study participants at University of Gondar Teaching Hospital from 1 January 2016 to 30 May 2016. Wound swab, aspirate, and biopsy were collected and performed for culture and drug resistance testing. Data were entered and analyzed by using SPSS version 20. Bivariate and multivariate logistic regression models were fitted to determine the associated factors for bacterial infection. Odds ratio (95% CI) was calculated to determine the strength of statistically significant associated factors. RESULT: Bacterial growth was confirmed in 90 (84.1%) of 107 study participants suspected to have surgical site infection. The predominant bacterial isolates were S. aureus (41.6%), E. coli (19.8%), K. pneumoniae (13.9%), coagulase negative Staphylococcus (12.9%), and Enterobacter spp. (4%). The majority of isolates were resistant to ampicillin, amoxicillin, and tetracycline but susceptible to ceftriaxone and amikacin. Multidrug-resistant bacteria species were isolated. Using a procedure such as cesarean section and episiotomy for delivery and premature rapture of membrane had strong association with bacterial infection. CONCLUSION: The high prevalence of bacterial profile and isolation of multidrug-resistant bacteria pose a big threat to postnatal mothers and their children. Factors such as cesarean section, episiotomy for delivery, and premature rapture of membrane were predictors for bacterial infection. Therefore, there should be done a continuous surveillance as well as rational use of antibiotics and a longitudinal study using phenotypic and genotypic methods will be done.