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    Mar 04, 2021
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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

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    Ngonzi et al - 2018 - Risk Factors ...
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    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
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    Issue Date
    2018-09-20
    Submitted date
    2018-10-04
    
    Metadata
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    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
    URI
    http://hdl.handle.net/10144/619277
    DOI
    10.1155/2018/6579139
    Additional Links
    https://www.hindawi.com/journals/ijmicro/2018/6579139/
    Language
    en
    ISSN
    1687-918X
    1687-9198
    ae974a485f413a2113503eed53cd6c53
    10.1155/2018/6579139
    Scopus Count
    Collections
    Womens/Reproductive Health

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