Vaginal Colonization and Susceptibility to Antibiotics of Enterococci During Late Pregnancy in Kerman City, Iran

Ghasemi, Ehsan; Mansouri, Shahla; Shahabi-Nejad, Naser

doi:10.5812/archcid.35428

Cited by 10 publications

(15 citation statements)

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“…Lastly, we found 8% vaginal enterococcus colonization in our study, the same proportion as in another study in pregnant women [ 9 ]. All enterococci isolated in our study were susceptible to both ampicillin and vancomycin, suggesting that postpartum enterococcal infections would likely be well treated by commonly used empiric antibiotic regimens, which usually include ampicillin.…”

Section: Discussionsupporting

confidence: 89%

“…Several bacterial pathogens such as group B Streptococcus ( Streptococcus agalactiae , GBS), Enterococcus spp., and Escherichia coli are known to be associated with poor obstetric and neonatal outcomes, even in women with uncomplicated labor [ 6 – 9 ]. We hypothesized that vaginal colonization with one or more of these known bacterial pathogens (GBS, E. coli , or Enterococcus spp.)…”

Section: Introductionmentioning

confidence: 99%

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Risk Factors for Vaginal Colonization and Relationship between Bacterial Vaginal Colonization and In-Hospital Outcomes in Women with Obstructed Labor in a Ugandan Regional Referral Hospital

Ngonzi

Bebell

Bazira

et al. 2018

International Journal of Microbiology

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Introduction The proportion of women with severe maternal morbidity from obstructed labor is between 2 and 12% in resource-limited settings. Maternal vaginal colonization with group B streptococcus (GBS), Escherichia coli, and Enterococcus spp. is associated with maternal and neonatal morbidity. It is unknown if vaginal colonization with these organisms in obstructed labor women is associated with poor outcomes. Objectives To determine whether vaginal colonization with GBS, E. coli, or Enterococcus is associated with increased morbidity among women with obstructed labor and to determine the risk factors for colonization and antibiotic susceptibility patterns. Methods We screened all women presenting in labor to Uganda's Mbarara Regional Referral Hospital maternity ward from April to October 2015 for obstructed labor. Those meeting criteria had vaginal swabs collected prior to Cesarean delivery and surgical antibiotic prophylaxis. Swabs were inoculated onto sterile media for routine bacterial culture and antimicrobial susceptibility testing. Results Overall, 2,168 women were screened and 276 (13%) women met criteria for obstructed labor. Vaginal swabs were collected from 272 women (99%), and 170 (64%) were colonized with a potential pathogen: 49% with E. coli, 5% with GBS, and 8% with Enterococcus. There was no difference in maternal and fetal clinical outcomes between those colonized and not colonized. The number of hours in labor was a significant independent risk factor for vaginal colonization (aOR 1.02, 95% CI 1.00–1.03, P=0.04). Overall, 38% of GBS was resistant to penicillin; 61% of E. coli was resistant to ampicillin, 4% to gentamicin, and 5% to ceftriaxone and cefepime. All enterococci were ampicillin and vancomycin susceptible. Conclusion There was no difference in maternal or neonatal morbidity between women with vaginal colonization with E. coli, GBS, and Enterococcus and those who were not colonized. Duration of labor was associated with increased risk of vaginal colonization in women with obstructed labor.

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Section: Discussionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Risk Factors for Vaginal Colonization and Relationship between Bacterial Vaginal Colonization and In-Hospital Outcomes in Women with Obstructed Labor in a Ugandan Regional Referral Hospital

Ngonzi

Bebell

Bazira

et al. 2018

International Journal of Microbiology

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“…During the initial database search, a total of 150 articles were found. After exclusion of the articles according to our criteria, a total of 44 articles were included in the analysis [3] , [6] , [7] , [8] , [9] , [10] , [11] , [12] , [13] , [14] , [15] , [16] , [17] , [18] , [19] , [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] , [39] , [40] , [41] , [42] , [43] , [44] , [45] , [46] , [47] , [48] . Among these 44 articles, 24 were associated with general patients (3071 isolates), 12 studies assessed their enterococcal populations on the basis of species (3906 isolates) and eight investigated colonization of enterococci among complicated patients with specific underlying conditions (589 isolates).…”

Section: Resultsmentioning

confidence: 99%

“…Moreover, no significant difference was seen where different methodologies were used. For example, a low mean rate of resistance was deduced for gentamycin during 2008 (7%), 2009 (6%) and 2014 (7%) [3] , [35] , [41] , [45] .…”

Section: Discussionmentioning

confidence: 99%

Rise of antibiotic resistance in clinical enterococcal isolates during 2001–2016 in Iran: a review

Asadollahi

Razavi

Asadollahi

et al. 2018

New Microbes and New Infections

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IntroductionThe clinical significance of enterococci is mostly related to its antibiotic resistance which contributes to colonization and infection, in particular amongst the hospitalized patients. The present review has examined the literature to provide a comprehensive data on enterococci antibiotic resistance during the last 20 years in Iran.MethodsSearch engines such as Google Scholar and PubMed were used to identify all Persian and English-language articles investigating enterococci in Iran from 1996 to 2017. The search terms were “enterococci”, “enterococcal”, “enterococcus”, “Iran”, “bacterial resistance”, “antibiotic resistance” and “resistance”.ResultsDecrease in the resistance trend against ampicillin, gentamycin and ciprofloxacin was observed over a period of 15 years (2001 to 2016) in Iran. During a 10 years period from 2001 to 2015, the rate of resistance among Enterococcus faecalis species was less than Enterococcus faecium. The resistancerate, however, was considerably increased for both species during this period. The mean resistance rates for vancomycin, gentamicin, ciprofloxacin, erythromycin, nitrofurantoin, chloramphenicol, trimethoprim-sulfametoxazol, imipenem and teicoplanin were higher among complicated cases (patients with underlying debilitating disorders) compared to general cases (hospitalized or outpatients with no specific underlying disorder).ConclusionsE. faecalis and E. faecium showed a rise in the mean resistance against all the antibiotics during a 10-year period from 2010 to 2015. With the exception of penicillin and ampicillin, resistance to all antibiotics was higher amongst complicated cases compared to general patients.

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“…Enterococci have previously been reported to be harmless inhabitants of the gastrointestinal tract flora initially, and are included among the main causes of health care-associated infections 76 , being recorded as the second most common cause of nosocomial urinary tract infections 77 . E. faecalis is considered to increase tst expression leading to increased production of toxic shock syndrome toxin-1 (TSST-1) thus increasing the virulence of S. aureus.…”

Section: Enterococcus Faecalismentioning

confidence: 99%

The Threat of Aerobic Vaginitis to Pregnancy and Neonatal Morbidity

Kaambo

Africa

2017

Afr J Reprod Health

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Aerobic vaginitis (AV) is an endogenous opportunistic infection brought about by the disruption of the normal vaginal microbiota. Its early diagnosis and treatment during pregnancy may reduce the risk of negative pregnancy outcomes. The aim of this review was to report on the aerobic bacteria most prevalent in AV and to provide evidence of the threat of untreated AV on pregnancy outcomes. More than 300 papers on preterm delivery were extracted from several research domains and filtered to include only AV-associated bacteria such as Staphylococcus aureus, Enterococcus faecalis, Escherichia coli and Group B streptococci and their association with adverse pregnancy outcomes. Due to the diverse sample groups, study techniques and outcomes, a meta-analysis was not conducted. The review revealed that the association of AV with adverse pregnancy outcomes has not been as widely researched as bacterial vaginosis (BV) and needs further investigation. Furthermore, the frequent misdiagnosis of AV coupled with the emerging antimicrobial resistance associated with bacteria implicated in AV and neonatal nosocomial infections pose a problem for prophylaxis and treatment to reduce the risk of maternal and neonatal morbidity and mortality. (Afr J Reprod Health 2017; 21[2]: 109-118). Keywords: Aerobic vaginitis; pregnancy risks; antimicrobial resistance RésuméLa vaginite aérobie (VA) est une infection opportuniste endogène provoquée par la perturbation du microbiota vaginal normal. Son diagnostic précoce et son traitement pendant la grossesse peuvent réduire le risque de résultats négatifs de grossesse. L'objectif de cette revue était de faire un rapport sur les bactéries aérobies les plus répandues en VA et de prouver la menace de la VA non traitée sur les résultats de la grossesse. Plus de 300 articles sur l'accouchement prématuré ont été tirés de plusieurs domaines de recherche et filtrés pour inclure uniquement des bactéries associées à la VA telles que Staphylococcus aureus, Enterococcus faecalis, Escherichia coli et streptocoques du groupe B et leur association avec des résultats de grossesse indésirables. En raison des divers groupes d'échantillons, des techniques d'étude et des résultats, une méta-analyse n'a pas été menée. L'examen a révélé que l'association de la VA avec les résultats de grossesse défavorisés n'a pas été aussi largement étudiée que la vaginose bactérienne (VB) et doit faire l'objet d'une enquête plus approfondie. En outre, le diagnostic erroné de la VA y compris la résistance antimicrobienne émergente associée à une bactérie impliquée dans les infections à vent et nonnéomatologiques constitue un problème pour la prophylaxie et le traitement afin de réduire le risque de morbidité et de mortalité maternelle et néonatale. (Afr J Reprod Health 2017; 21[2]: 109-118).

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Vaginal Colonization and Susceptibility to Antibiotics of Enterococci During Late Pregnancy in Kerman City, Iran

Cited by 10 publications

References 28 publications

Risk Factors for Vaginal Colonization and Relationship between Bacterial Vaginal Colonization and In-Hospital Outcomes in Women with Obstructed Labor in a Ugandan Regional Referral Hospital

Risk Factors for Vaginal Colonization and Relationship between Bacterial Vaginal Colonization and In-Hospital Outcomes in Women with Obstructed Labor in a Ugandan Regional Referral Hospital

Rise of antibiotic resistance in clinical enterococcal isolates during 2001–2016 in Iran: a review

The Threat of Aerobic Vaginitis to Pregnancy and Neonatal Morbidity

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