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

Hdl Handle:
http://hdl.handle.net/10144/619277
Title:
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
Authors:
Ngonzi, J; Bebell, LM; Bazira, J; Fajardo, Y; Nyehangane, D; Boum, Y; Nanjebe, D; Boatin, A; Kabakyenga, J; Jacquemyn, Y; Van Geertruyden, JP; Riley, LE
Journal:
International Journal of Microbiology
Abstract:
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.
Publisher:
Hindawi Publishing Corporation
Issue Date:
20-Sep-2018
URI:
http://hdl.handle.net/10144/619277
DOI:
10.1155/2018/6579139
Additional Links:
https://www.hindawi.com/journals/ijmicro/2018/6579139/
Submitted date:
2018-10-04
Language:
en
ISSN:
1687-918X; 1687-9198
Appears in Collections:
Womens/Reproductive Health

Full metadata record

DC FieldValue Language
dc.contributor.authorNgonzi, Jen
dc.contributor.authorBebell, LMen
dc.contributor.authorBazira, Jen
dc.contributor.authorFajardo, Yen
dc.contributor.authorNyehangane, Den
dc.contributor.authorBoum, Yen
dc.contributor.authorNanjebe, Den
dc.contributor.authorBoatin, Aen
dc.contributor.authorKabakyenga, Jen
dc.contributor.authorJacquemyn, Yen
dc.contributor.authorVan Geertruyden, JPen
dc.contributor.authorRiley, LEen
dc.date.accessioned2018-10-16T16:41:06Z-
dc.date.available2018-10-16T16:41:06Z-
dc.date.issued2018-09-20-
dc.date.submitted2018-10-04-
dc.identifier.citationRisk 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 2018, 2018:1 International Journal of Microbiologyen
dc.identifier.issn1687-918X-
dc.identifier.issn1687-9198-
dc.identifier.doi10.1155/2018/6579139-
dc.identifier.urihttp://hdl.handle.net/10144/619277-
dc.description.abstractIntroduction . 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.en
dc.language.isoenen
dc.publisherHindawi Publishing Corporationen
dc.relation.urlhttps://www.hindawi.com/journals/ijmicro/2018/6579139/en
dc.rightsArchived with thanks to International Journal of Microbiologyen
dc.titleRisk Factors for Vaginal Colonization and Relationship between Bacterial Vaginal Colonization and In-Hospital Outcomes in Women with Obstructed Labor in a Ugandan Regional Referral Hospitalen
dc.identifier.journalInternational Journal of Microbiologyen
dc.contributor.institutionMbarara University of Science and Technology, Department of Obstetrics and Gynecology, Mbarara, Uganda-
dc.contributor.institutionDivision of Infectious Diseases, Massachusetts General Hospital, Boston, MA, USA-
dc.contributor.institutionMbarara University of Science and Technology, Department of Microbiology, Mbarara, Uganda-
dc.contributor.institutionMbarara University of Science and Technology, Department of Obstetrics and Gynecology, Mbarara, Uganda-
dc.contributor.institutionEpicentre Mbarara Research Base, Mbarara, Uganda-
dc.contributor.institutionEpicentre Mbarara Research Base, Mbarara, Uganda-
dc.contributor.institutionEpicentre Mbarara Research Base, Mbarara, Uganda-
dc.contributor.institutionMassachusetts General Hospital Center for Global Health, Boston, MA, USA-
dc.contributor.institutionMbarara University of Science and Technology, Institute of Maternal Newborn and Child Health, Mbarara, Uganda-
dc.contributor.institutionGlobal Health Institute, University of Antwerp, Antwerp, Belgium-
dc.contributor.institutionGlobal Health Institute, University of Antwerp, Antwerp, Belgium-
dc.contributor.institutionDivision of Obstetrics and Gynecology, Massachusetts General Hospital, Boston, MA, USA-
All Items in MSF are protected by copyright, with all rights reserved, unless otherwise indicated.