BACTERIAL ISOLATES AND ANTIMICROBIAL SUSCEPTIBILITY PATTERNS AMONG WOMEN SUFFERING FROM PUERPERAL SEPSIS AT FELEGEHIWOT REFERRAL HOSPITAL, BAHIR DAR TOWN, NORTHWEST ETHIOPIA

Abstract

Background: Puerperal sepsis also known as postpartum sepsis is any bacterial infection of the female reproductive tract or blood stream following childbirth that occurs within forty two days following delivery. It is among the leading causes of maternal morbidity and mortality both in developing and developed countries. Objective: The overall aim of this study was to determine bacterial profile and antimicrobial susceptibility pattern among women suffering from puerperal sepsis. Methods: A cross sectional study was conducted among puerperal sepsis suspected patients visiting Felege Hiwot Referral Hospital from January to May 2017. A total of 166 study participants with symptoms and clinical signs of puerperal sepsis were included in the study. Blood sample was collected, inoculated into Trypton soya broth medium and incubated at 37oC. After 24 hours of incubation, samples were sub-cultured in to blood agar plate, chocolate agar plate and MacConkey agar. After 7 days, cultures were considered free of microorganisms. Bacterial pathogens and antimicrobial susceptibility patterns were identified using VITEK 2 Rapid Identification and Susceptibility Testing System. Results: The overall prevalence of bacterial pathogens among women suspected of puerperal sepsis was 33.7%; of which 55.4% and 44.6% were Gram negative and Gram positive bacterial isolates respectively. Identified isolates were S. aureus 19(33.9%), E. coli 18(32.1%), K. pneumoniae 7(12.5%) and A. baumannii 6(10.7%). The proportion of Coagulase Negative Staphylococcus and R. ornithinolytica was 4(7.2 %) and 2(3.6%) respectively. Antimicrobial susceptibility patterns were found 100% in both Tetracycline and Ampicillin in Gram positive isolates whereas 100% and 93.9% to Ampicillin and Tetracycline respectively for Gram negatives. The overall multidrug resistance was 47(84%). Multiparous had shown four times more likely to develop sepsis than primiparous. Conclusion: Puerperal sepsis is one of the postpartum complications mostly associated with bacteria and it results in maternal mortality if it is left untreated. The study identified S. aureus and E. coli to be most commonly isolated bacteria from puerperal sepsis patients; and the rate of multidrug resistance among isolated bacteria was found to be high