Myanmar Health Sciences Research Journal
Volume 24, Number 3
TITLE: In-vitro antimicrobial resistance among predominant bacterial pathogens isolated from septic abortion cases in North Okkalapa General Hospital.
AUTHOR: Wah Wah Aung; Win Win Mya; Hta Hta Yi; Saw Kler Ku; Phyu Win Ei; Nan Aye Thida Oo
SOURCE: Myanmar Health Sciences Research Journal. 2012; 24(3): 168-174
ABSTRACT: Septic abortion is a major health challenge leading to maternal morbidity and mortality in developing countries. Antibiotic therapy contributes to an important role along with the removal of septic focus by evacuation of retained products of conception. A cross-sectional descriptive study was carried out to determine the bacteriological spectrum and antibiotic susceptibility pattern of septic abortion cases admitted to North Okkalapa General Hospital during 2009-2010. Blood and endocervical swab cultures were performed to identify bacterial pathogens using standard micro- biological techniques. The isolates were subjected to antibiotic susceptibility tests using the disc diffusion method. Of 160 septic abortion cases, pathogenic aerobic bacteria were isolated in 54.4% (87/160) and septicaemia proven by blood culture was found in 17.5% (28/160). Staphylococcus aureus was the most prevailing bacterial pathogen comprising 36.8% (32/87) of culture-positive cases. Escherichia coli was the second most commonly isolated bacterial pathogen accounting for 29.9% (26/87). Antibiotic susceptibility of Staphylococcus aureus indicated 72-94% sensitivity to amoxicillin-fluocloxacillin, cefoperazone-sulbactam, cefipime and piperacillin-tazobactam. However, 63-97% resistance to ceftriazone, amoxicillin-clavulanic acid and penicillin was found. Methicillin-resistant Staphylococcus aureus strains were found in 20% (5/25) of Staphylococcus aureus isolates. Escherichia coli isolates showed 75-88% sensitivity to cefoperazone-sulbactam, cefotaxime, ceftazidime, piperacillin-tazobactam and cefipime; and 58-96% resistance to ceftriazone, ofloxacin, ciprofloxacin and penicillin. Extended-spectrum beta-lactamase producing Escherichia coli were found in 11.5% (3/26) of Escherichia coli isolates. The present study highlighted the emergence of multidrug-resistant bacterial pathogens and provided the information for development of effective updated antibiotic regime for septic abortion.
SUBJECT HEADINGS: Abortion, Septic