title: Cervicovaginal Bacteriology and Antibiotic Sensitivity Patterns among Women with Premature Rupture of Membranes in Mulago Hospital, Kampala, Uganda: A Cross-Sectional Study.
abstract: Background. A 2013 Cochrane review concluded that the choice of antibiotics for prophylaxis in PROM is not clear. In Uganda, a combination of oral erythromycin and amoxicillin is the 1st line for prophylaxis against ascending infection. Our aim was to establish the current cervicovaginal bacteriology and antibiotic sensitivity patterns.Methods. Liquor was collected aseptically from the endocervical canal and pool in the posterior fornix of the vagina using a pipette. Aerobic cultures were performed on blood, chocolate, and MacConkey agar and incubated at 35-37°C for 24-48 hrs. Enrichment media were utilized to culture for GBS and facultative anaerobes. Isolates were identified using colonial morphology, gram staining, and biochemical analysis. Sensitivity testing was performed via Kirby-Bauer disk diffusion and dilution method. Pearson's chi-squared (χ2) test and the pairedt-test were applied, at aPvalue of 0.05.Results. Thirty percent of the cultures were positive and over 90% were aerobic microorganisms. Resistance to erythromycin, ampicillin, cotrimoxazole, and ceftriaxone was 44%, 95%, 96%, and 24%, respectively. Rupture of membranes (>12 hrs), late preterm, and term PROM were associated with more positive cultures.Conclusion. The spectrum of bacteria associated with PROM has not changed, but resistance to erythromycin and ampicillin has increased.
authors.affiliation: Mbale Regional Referral & Teaching Hospital, P.O. Box 921, Mbale, Uganda.
authors.forename: Milton W
authors.identifier: 0000-0003-4145-4044
authors.initials: MW
authors.lastname: Musaba
authors.affiliation: School of Medicine, College of Health Sciences, Makerere University, P.O. Box 7072, Kampala, Uganda.
authors.forename: Mike N
authors.initials: MN
authors.lastname: Kagawa
authors.affiliation: Mulago National Referral & Teaching Hospital, P.O. Box 7051, Kampala, Uganda.
authors.forename: Charles
authors.initials: C
authors.lastname: Kiggundu
authors.affiliation: School of Medicine, College of Health Sciences, Makerere University, P.O. Box 7072, Kampala, Uganda.
authors.forename: Paul
authors.initials: P
authors.lastname: Kiondo
authors.affiliation: Faculty of Health Sciences, Busitema University, P.O. Box 1460, Mbale, Uganda.
authors.forename: Julius
authors.initials: J
authors.lastname: Wandabwa
mesh_terms: D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D001419:Bacteria / Q000187:drug effects* / Q000302:isolation & purification; D001424:Bacterial Infections / Q000453:epidemiology / Q000382:microbiology*; D002584:Cervix Uteri / Q000382:microbiology*; D003430:Cross-Sectional Studies; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000453:epidemiology / Q000382:microbiology*; D006801:Humans; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology / Q000382:microbiology*; D014454:Uganda / Q000453:epidemiology; D014621:Vagina / Q000382:microbiology*; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents