Microbial isolates and antibiotic sensitivity pattern among women with early preterm spontaneous prelabor rupture of fetal membranes in a Nigerian teaching hospital

Abstract

Background: Preterm prelabor rupture of membranes (PPROM) is a significant risk factor for prematurity, maternal, and early-onset neonatal sepsis. A study of the microbial isolates and antibiotic sensitivity pattern is needed in a resource poor country. Objectives: To identify the microbial isolates and antibiotic sensitivity pattern of patients with early PPROM. Materials and Methods: It was a comparative study between 60 pregnant women who had PPROM and 60 matched controls without PPROM. Study variables of interest were sociodemographic characteristics and gestational age at recruitment, microbial isolates, and antibiotic sensitivity pattern. Data obtained were presented in tabular forms and recorded as frequencies and percentages. x2 and students' t – tests were used to compare qualitative and quantitative variables, respectively. Statistical significance was considered at P value < 0.05. Results: Sociodemographic characteristics did not show any significant association between the two groups except for social class (x2 = 11.659, P = 0.003) and booking status (x2 = 53.494, P < 0.001). Positive culture rate of 51 (85.0%) and 9 (15.0%) were found in the PPROM and non-PPROM groups, respectively. Escherichia coli 18 (30.0%) was the most frequently isolated organism in the PPROM group. Chlamydia trachomatis antigen was detected in six cases (10.0%) among the PPROM group. Antibiotics that had excellent sensitivity to the isolated organisms were meropenem, ceftazidime, and piperacillin. Conclusion: Genital tract infection was significantly related to the occurrence of PPROM and E. coli was the commonest microbial organism isolated. Intravenous ceftriaxone followed by oral cefixime met national institute of child health and human development, maternal-fetal medicine units (NICHD-MFMU) criteria for selection as prophylactic antibiotic in PPROM.