A study of predisposing factors and microbial flora in puerperal sepsis

Kaur, Tajinder; Mor, Sunita; Puri, Meenu; Sood, Ruchika; Nath, Jayati

doi:10.18203/2320-1770.ijrcog20163000

Cited by 13 publications

(16 citation statements)

References 9 publications

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“…This is similar with the study report from Tanzania and Zimbabwe [12] where E. coli and Klebsiella species were the majority bacterial isolates from puerperal septic patients. However, our ndings is different from other study ndings where group A streptococcus, group B streptococcus, Bacteroides species, Pseudomonas aeruginosa, Proteus, and Enterococcus species were the dominant isolates [14,15,21,22].…”

Section: Discussioncontrasting

confidence: 99%

Puerperal sepsis: Bacterial profile, Antimicrobial susceptibility patterns and Associated factors at Asella Referral and Teaching Hospital, Central Ethiopia: Cross sectional study

Godana¹,

Gashaw

Abdulsemed

et al. 2022

Preprint

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Background: Sepsis is a major cause of maternal death worldwide and caused by a variety of bacterial pathogens. In many developing countries including Ethiopia, the treatment of puerperal sepsis is based on empirical/syndromic that may promote antimicrobial resistance. Therefore the aim of this study was to investigate bacterial pathogens, their antimicrobial susceptibility patterns, and associated factors among women with suspected puerperal sepsis. Methods: A cross-sectional study was conducted among puerperal sepsis suspected women attending Asella Referral and Teaching Hospital, from September 2020 to August 2021. A total of 174 study participants were enrolled. Sociodemographic and obstetric data of the participants were collected using a pretested structured questionnaire and checklist respectively. About 20 ml blood sample was collected from all study participants into BacT/ALERT® 3D blood culture bottles and incubated into BacT/ALERT® 3D automated blood culture system. Endocervical swab was also collected into Aime's transport media. Bacterial isolation and identification was done using standard bacteriological methods. Disc diffusion method was used to determine the antimicrobial susceptibility profiles of bacterial isolates. Data were entered into EpiData version 4.6 and transferred to SPSS version 25.0 for analysis. Results: The overall positivity rate of bacterial isolates among puerperal sepsis suspected women was 48.9%. Out of these 87.1% of the isolates were Gram negative bacteria. The most common isolates were E. coli (54.1%) followed by Klebsiella spp. (23.5%) and S. aureus (10.6%). E. coli showed a higher resistance rate to Piperacillin (87%). Klebsiella spp. showed a higher resistance rate to Aztreonam (65%) and Ceftriaxone (65%). S. aureus showed a higher resistance rate to Trimethoprim-sulfamethoxazole (66.6%). In this study, 81.2% of the isolates were multi-drug resistant bacterial pathogens. Multivariate regression analysis showed no statistically significant association between sociodemographic, obstetrics factors, and having bacteria. Conclusion: In this study the overall positivity rate in this study was 48.9%. E. coli, Klebsiella species, and S. aureus were the most common isolated bacteria. High numbers of multidrug-resistant bacterial isolates were identified. Our finding emphasizes the need for strengthening microbiology services for better management of patients.

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Section: Discussioncontrasting

confidence: 99%

Puerperal sepsis: Bacterial profile, Antimicrobial susceptibility patterns and Associated factors at Asella Referral and Teaching Hospital, Central Ethiopia: Cross sectional study

Godana¹,

Gashaw

Abdulsemed

et al. 2022

Preprint

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“…Those mothers who had > = 5 times vaginal examination during delivery had 4.0 times more likely to develop puerperal sepsis compared to those who had Vaginal examination 1–2 times. This is in a row with study conducted in Egypt which indicated that having > = 5 times vaginal examination can lead in developing puerperal sepsis [ 14 , 15 ].Similarly systemic review study conducted in south Asia evidenced that putting hands, frequently in vagina end with puerperal sepsis [ 16 ]. Study from Kenya reported that women who had 2or more vaginal examination were 3.95 times more likely to develop puerperal sepsis [ 17 ].This frequent manipulation of genital tracts will facilitate ascension of microorganisms from lower genital tract and thereby increase in probability to develop puerperal sepsis.…”

Section: Discussionmentioning

confidence: 57%

Section: Discussionmentioning

confidence: 67%

Determinants of puerperal sepsis among post partum women at public hospitals in west SHOA zone Oromia regional STATE, Ethiopia (institution BASEDCASE control study)

Demisse

Sifer

Kedir³

et al. 2019

BMC Pregnancy Childbirth

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BackgroundPuerperal sepsis is an infection of the genital tract, which occurs from rupture of amniotic sacs and within 42ndday after delivery. It happens mainly after discharge in the 1st 24 h of parturition. It is the third leading cause of direct maternal mortality in developing nations. It is also among preventable conditions. Even though multiple interventions were done to overcome these health problems, maternal mortality and morbidities were still significant. Mainly, in Ethiopia lack of clearly identified causes of maternal mortality and morbidity makes the problem unsolved.MethodsCase-control study was conducted at public Hospitals in west shoa zone Oromia regional state, Ethiopia from February 01 to April 30/2018.women with puerperal sepsis (n = 67) were selected by convenience method. Controls (n = 213) were selected by systematic random sampling. Controls to cases ratio was 3:1 and structured questionnaire was used to interviewafter verbal consent was obtained. Data was entered in to epi –info 7.2 then exported to SPSS version 20.0 for analysis. A logistic regression model was used for data analysis. Those variables which have p-value < 0.05 were accepted that they are independent determinants of puerperal sepsis.ResultRural residence (AOR [95%CI] = 2.5(1.029–6.054),Mothers with no formal education (AOR [95%CI] = 6.74([1.210–37.541]), up to primary level of education(AOR [95%CI] = 6.72(1.323–34.086), total monthly income of the mother or family<=500 ETB and 501–1500 ETB(AOR [95%CI] = 5.94(1.471–23.93) and (AOR [95%CI] =6.57 (1.338–32.265) respectively, Mothers having 1–2 times antenatal care(ANC)visit (AOR [95%CI] = 6.57([1.338–32.265]), Duration of Labor12–24 h (AOR [95%CI] = 3.12 (1.805–12.115),> = 25 h (AOR [95%CI] = 4.71([1.257–17.687]),vaginal examinations > = 5times (AOR [95%CI] = 4.00([1.330–12.029]), Delivery by C/S (AOR [95%CI] = 3.85 ([1.425–10.413]), Rupture of membrane > 24 h (AOR [95%CI] = 3.73([1.365–10.208]) and those Referred from other health institutions (AOR [95%CI] = 2.53([1.087–5.884],were independent determinants of puerperal sepsis in this study.ConclusionMajority of determinants of puerperal sepsis were related with pregnancy and childbirth. Therefore, to tackle a problem of puerperal sepsis all concerning bodies should take measures during prenatal, natal and postnatal period.Electronic supplementary materialThe online version of this article (10.1186/s12884-019-2230-x) contains supplementary material, which is available to authorized users.

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“…Kaur et al in her study showed Staphylococcus aureus and Escherichia coli to be the two most common organisms isolated accounting for 36% and 29.8% of cases. 17 Tamboli et al isolated Kleibsiella aerogenes and Escherichia coli to be the most common organisms in his study. 15 Venugopal et al in his study isolated Escherichia coli to be the most common organism.…”

Section: Figure 1: Age Distribution Of Various Patients In the Studymentioning

confidence: 94%

“…14 Kaur et al also reported primigravidae to be significant. 17 Bako in Nigeria 18 too showed primi to be a risk factor. 18 Pradhan et al in Nepal also found primigravida to be associated with increased puerperal sepsis.…”

Section: Figure 1: Age Distribution Of Various Patients In the Studymentioning

confidence: 96%

Clinicopathological study of puerperal sepsis including microbiological profile: at a tertiary health care centre

Bassetty

Ahmed

Saikia

2018

Int J Reprod Contracept Obstet Gynecol

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Background: Puerperal sepsis in developing countries is a major health problem. Antenatal and labour related risk factors play a huge role in causing puerperal sepsis, many of which are modifiable. The aim of the present study is to study the risk factors, clinical features and outcomes of puerperal sepsis in the mother and determine the causative microorganisms involved.Methods: A prospective observational study was conducted at the department of Obstetrics and Gynaecology, Assam Medical college and Hospital from 1st July 2016 to 30th June 2017.Peurperal sepsis cases were identified based on the WHO clinical definition. A total of 88 patients were identified. Information regarding occupation, antenatal care, delivery related events and outcome were recorded on a predesigned proforma. Mothers were followed up till discharge from the hospital.Results: Out of 88 clinically diagnosed patients with puerperal sepsis, common risk factors associated with mortality were young age(p<0.001),primiparity(p 0.005),tea garden workers(p 0.014),few antenatal check-ups and unbooked status (p 0.001) inadequate iron prophylaxis .Among labor related events intrauterine fetal demise (p 0.001), absent membranes on admission (0.001),late presentation (p 0.001) delivery by untrained birth attendant (p <0.001) were significant.24 patients expired due to the disease. Most common isolated in high vaginal swab and blood culture were Klebsiella pneumoniae and CONS respectively.Conclusions: Proper antenatal care and institutional deliveries are the prime and only preventive measure to reduce the burden of puerperal sepsis in our setup.

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A study of predisposing factors and microbial flora in puerperal sepsis

Cited by 13 publications

References 9 publications

Puerperal sepsis: Bacterial profile, Antimicrobial susceptibility patterns and Associated factors at Asella Referral and Teaching Hospital, Central Ethiopia: Cross sectional study

Puerperal sepsis: Bacterial profile, Antimicrobial susceptibility patterns and Associated factors at Asella Referral and Teaching Hospital, Central Ethiopia: Cross sectional study

Determinants of puerperal sepsis among post partum women at public hospitals in west SHOA zone Oromia regional STATE, Ethiopia (institution BASEDCASE control study)

Clinicopathological study of puerperal sepsis including microbiological profile: at a tertiary health care centre

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