Title: Study of Bacterial Isolates in Puerperal Sepsis & its Antibiotic Sensitivity Pattern
Authors: Dr Kishor V. Ingole, Dr Preeti P. Shendre
DOI: https://dx.doi.org/10.18535/jmscr/v5i3.49
Abstract
2) To find out it’s antibiotic sensitivity pattern.
3) To find out associated risk factors for puerperal sepsis.
Materials & Methods: This Cross Sectional study was carried out for a period of 2 years from December 2014 to September 2016. The clinically suspected cases of puerperal sepsis were included in this study. Endocervical swab or secretion and blood from each case were collected following standard procedure for microscopic examination and isolation of bacteria with antimicrobial susceptibility. The isolates were identified on the basis of colony morphology, from colony Gram staining and appropriate biochemical tests. The isolates were identified per standard biochemical testing and antibiotic sensitivity testing was done as per CLSI guidelines.
Observation & Result: Out of 67 women admitted in present study, majority 54 (80.59 %) were between 20 and 29 years of age. Majority of them were uniparous (50.74 %). 46 showed bacterial growth rests of the samples were sterile. Gram negative organisms were isolated in 31 cases (67.39 %) while Gram positive organisms in 15 cases (32.60 %). Klebsiella was the most frequent isolate 13 (28.26%) followed by Staph. aureus 10 (21.73%). In the present study, out of 67 cases studied, bacteremia was present in 46 (68.65%) cases. Present study shows predominance of Gram negative bacilli (67.39%) with 32.60% isolates being Gram positive cocci.
Conclusion: In view of the changing spectrum of the causative agents of puerperal sepsis and their antibiotic sensitivity patterns from time to time and from one hospital to another, a positive blood culture and the antibiotic susceptibility testing of the isolates are the best guide in choosing the appropriate antimicrobial therapy in treating puerperal sepsis.
Keywords: Purperal sepsis, antibiotic sensitivity pattern, blood culture.References
1. Maharaj D. Puerperal pyrexia; a review. Part II. Obstet Gynecol Surv. 2007;62 (6):400-6.
2. Kumar R, Sharma AK, Barik S, Kumar V. Maternal mortality inquiry in a rural community of north India. Int J Gynaecol Obstet. 1989;29:313-9.
3. Daftary SN, Chakravarti S. Obstetric shock. Manual of Obstetric, 2nd Edition; Elsevier publisher. 2005.
4. Abouzahr C ,Aahman E.,Guidotti R. Puerperal sepsis and other puerperal infections. Health organization and the world bank.1998;pg-191-217
5. V.Ruthbeneth.LindaK.Brown.Textbook of Myles.Third edition 2001.pg-589
6. WHO, 2004; Basu, 2003
7. Duguid JP, MacKie and McCartney Practical Medical Microbiology. Collee JG, Duguid JP, Fraser AG, Marmion BP (editors).13th ed. Churchill. Livingstone, New York.1989; 2:360-396.
8. Cheesbrough M. District laboratory practice in tropical countries, vol 2, Low price edition, University of Cambridge, United Kingdom 2000.
9. Blazevic DJ, Stemper JE & Master JM. Comparison of macroscopic examination .Routine Gram stains and Routine sub-culture in the initial detection of positive blood culture. Applied Microbial. 1974; 27: 37-539.
10. Naheed T, Akbar N. Patients with postpartum complications admitted in a Medical ward of Mayo Hospital, Lahore, Pakistan. J Med Sc. 2002;18(2):126-30.
11. Chaisilwatana P, Roongpisuthipong A. Causative organisms in puerperal sepsis. J Med Assoc Th. 1991;74(3):159-61.
12. Rao K, Ramji S, Thirupuram S, Prakash K. Clinical and bacteriological study of normal and inflamed neonatal conjunctiva. Indian Pediatr. 1992;29:161-5.
13. Kerur BM, Batt BV, Harish BN, Habeebullah S, Kumar CU. Maternal genital bacteria and surface colonization in early neonatal sepsis. Indian J Pediatr. 2006;73(1):29-32.
14. Venugopal MS, Bhaskaran CS. Puerperal and postabortal sepsis (a bacteriological study). J ObstetGynaecol India. 1968;18 (1):70-8.
15. Omu AE, Ajabor LN.Contribution of endotoxic shock to gynecological and maternal morbidity and mortality.J Obstet Gynaecol East Cent Africa.1983;2(1):41-5.
16. Baker JN. Study of cases of puerperal pyrexia in a tertiary level hospital. [Dissertation] Dhaka, Bangladesh: Sir Salimullah Medical College and Mitford hospital. 2005:34.
17. Decherny AH, Nathan L. Postpartum hemorrhage and the abnormal puerperium In: Current Obstetrics and Gynecologic diagnosis and treatment, 9th ed. UK: Pren-tice Hall International Inc. 2003:531-52.
18. Gerstner G, Leodolter S, Rotter M. Endo-metrial bacteriology in puerperal infecti-ons. Z. GeburtshilfePerinatol. 1981;185 (5):276-9.
19. Newsom Sw. Pioneers in infection control. Ignaz Philip Semmelweis. J Hosp Infect. 1993;23:175-87.
20. Pokharel MS. Study on antibiotic sensitivity pattern of bacterial flora in cases of pre-labor rupture of membranes. [Dissertation] Kathmandu, Nepal: Tribhuvan University. 2004:108.
21. Modi S, Kar J, Gupta.Puerperalsepsis.Cur MedPract.1986;30(12):301-6
22. Martens MG, Faro S, Maccato M, Riddlw G, Hammill HA. Susceptibility of female pelvic pathogens to oral antibiotic agents in patients who develop postpartum Endometritis. AM J Obstet Gynecol. 1991;164:1383-6.