Microbial Milieu and Antibiogram of Female Genital Infections in a Tertiary Health Facility in Nigeria

Overview

Journal Niger Med J

Specialty General Medicine

Date 2024 Jun 13

PMID 38867752

Authors

Simeon Chijioke Amadi

Abbey Mkpe

Abimbola Temitayo Oluwajenyo Awopeju

Rose Sitonma Iwo-Amah

Anthony Chukwuemeka Olobuah

Affiliations

Soon will be listed here.

Abstract

Background: Vaginal infections constitute a significant health challenge for women and lead to long-term complications if not promptly and adequately treated. We aimed to determine the prevalent organisms in vaginal infections in our women and the antibiotic susceptibility of the offending organisms.

Methodology: This was a prospective cross-sectional study of 635 consecutive women attending the Obstetrics and Gynaecology clinic of the University of Port Harcourt Teaching Hospital from 1 January 2017 to 31 December 2018. Data obtained were analysed using SPSS version 19.

Results: Four hundred and eight (64.3%) of the women were gynaecological patients, while the remaining 227 (35.7%) were obstetric patients. One hundred and ninety-one(30.1%) out of the total 635 study population did not have any growth of the organisms tested for in the culture assay, while the remaining 444 (69.9%) had. One hundred and forty-four of the women(22.2%) had growth of candida Albicans, 130 (20.5%) had staphylococcus aureus, 78 (12.3%) - Klebsiella species (spp), 48 (7.6%) - Escherichia coli, 30 (4.7%) - Pseudomonas species, 8 (1.3%) - Proteus species and 6 (0.9%) of the women had Streptococcus species. The commonest pathogen involved in vaginal infections in women was Candida albicans. The commonest bacterial isolate was Staphylococcus aureus and then Klebsiella species. The bacteria were susceptible to Ceftriaxone, Cefpodoxime, Cefotaxime, Cefixime, Ciprofloxacin, Dorepenem and Ampicillin. They were mainly resistant to cefuroxime, ceftazidime, Augmentin, Erythromycin and Meropenem.

Conclusion: Candida albicans is prevalent in our women. Staphyloccocus aureus is the commonest bacterial organism in women with vaginal infections. Empirical antibiotic treatment using Cetriazone, Cefpodoxime and Ciprofloxacin, available in our setting, may be beneficial while awaiting the culture results in women with suspected vaginal infections.

References

Ghafur A, Mathai D, Muruganathan A, Jayalal J, Kant R, Chaudhary D . The Chennai Declaration: a roadmap to tackle the challenge of antimicrobial resistance. Indian J Cancer. 2013; 50(1):71-3. DOI: 10.4103/0019-509X.104065. View

Go V, Quan V, Celentano D, Moulton L, Zenilman J . Prevalence and risk factors for reproductive tract infections among women in rural Vietnam. Southeast Asian J Trop Med Public Health. 2006; 37(1):185-9. View

Trabert B, Misra D . Risk factors for bacterial vaginosis during pregnancy among African American women. Am J Obstet Gynecol. 2007; 197(5):477.e1-8. PMC: 2290855. DOI: 10.1016/j.ajog.2007.03.085. View

Saleh A, Abdalla H, Satti A, Babiker S, Gasim G, Adam I . Diagnosis of Trichomonous vaginalis by microscopy, latex agglutination, diamond's media, and PCR in symptomatic women, Khartoum, Sudan. Diagn Pathol. 2014; 9:49. PMC: 3975644. DOI: 10.1186/1746-1596-9-49. View

Spinillo A, Bernuzzi A, Cevini C, Gulminetti R, Luzi S, DE Santolo A . The relationship of bacterial vaginosis, Candida and Trichomonas infection to symptomatic vaginitis in postmenopausal women attending a vaginitis clinic. Maturitas. 1997; 27(3):253-60. DOI: 10.1016/s0378-5122(97)00038-8. View

Mumtaz S, Ahmad M, Aftab I, Akhtar N, Hassan M, Hamid A . Aerobic vaginal pathogens and their sensitivity pattern. J Ayub Med Coll Abbottabad. 2008; 20(1):113-7. View

Sonkar S, Arora G, Wasnik K, Ali M, Mittal P, Saluja D . Improved management can be achieved by introducing additional parameters in the syndromic diagnosis of nonviral sexually transmitted infections at low-resource settings. AJOG Glob Rep. 2022; 2(1):100037. PMC: 9563558. DOI: 10.1016/j.xagr.2021.100037. View

Shrestha S, Tuladhar N, Basnyat S, Acharya G, Shrestha P, Kumar P . Prevalence of vaginitis among pregnant women attending Paropakar Maternity and Women's Hospital, Thapathali, Kathmandu, Nepal. Nepal Med Coll J. 2012; 13(4):293-6. View

Fang X, Zhou Y, Yang Y, Diao Y, Li H . Prevalence and risk factors of trichomoniasis, bacterial vaginosis, and candidiasis for married women of child-bearing age in rural Shandong. Jpn J Infect Dis. 2007; 60(5):257-61. View

10.

Tariq N, Jaffery T, Ayub R, Alam A, Javid M, Shafique S . Frequency and antimicrobial susceptibility of aerobic bacterial vaginal isolates. J Coll Physicians Surg Pak. 2006; 16(3):196-9. DOI: 3.2006/JCPSP.196199. View

11.

Prestinaci F, Pezzotti P, Pantosti A . Antimicrobial resistance: a global multifaceted phenomenon. Pathog Glob Health. 2015; 109(7):309-18. PMC: 4768623. DOI: 10.1179/2047773215Y.0000000030. View

12.

Mulu W, Yimer M, Zenebe Y, Abera B . Common causes of vaginal infections and antibiotic susceptibility of aerobic bacterial isolates in women of reproductive age attending at Felegehiwot Referral Hospital, Ethiopia: a cross sectional study. BMC Womens Health. 2015; 15:42. PMC: 4438529. DOI: 10.1186/s12905-015-0197-y. View

13.

Begum A, Nilufar S, Akther K, Rahman A, Khatun F, Rahman M . Prevalence of selected reproductive tract infections among pregnant women attending an urban maternal and childcare unit in Dhaka, Bangladesh. J Health Popul Nutr. 2003; 21(2):112-6. View

14.

Fair R, Tor Y . Antibiotics and bacterial resistance in the 21st century. Perspect Medicin Chem. 2014; 6:25-64. PMC: 4159373. DOI: 10.4137/PMC.S14459. View

15.

Haltas H, Bayrak R, Yenidunya S . To determine of the prevalence of Bacterial Vaginosis, Candida sp, mixed infections (Bacterial Vaginosis + Candida sp), Trichomonas Vaginalis, Actinomyces sp in Turkish women from Ankara, Turkey. Ginekol Pol. 2013; 83(10):744-8. View