Abstract:

Introduction: Blood stream infections are major complications among women with puerperal sepsis particularly in the resources limited countries. Despite being common in these countries, there is limited information on the pathogens implicated and their resistance pattern, as the majority of previous studies relied on clinical diagnosis. This study investigated bacterial pathogens implicated, antimicrobial susceptibility patterns and underlying factors for blood stream infections among women with puerperal sepsis in Mwanza, Tanzania.

Methodology: A hospital based cross-sectional study was conducted in Mwanza from October 2017 to April 2018. Socio-demographic and other relevant information were collected. Blood sample was collected and analysed using standard procedures to isolate bacterial pathogens, and antimicrobial susceptibility testing was done by the Kirby-Bauer test. Data were analysed using STATA version 13 Software.

A total of 340 participants were enrolled with mean age ± standard deviation of 26.2 ± 6.5 years. The overall culture positive was 10.6% (36/340), with predominance of Staphylococcus aureus 36.1% (13/36). Laboratory confirmed blood stream infections was significantly associated with women who were primipara (p=0.04), those who were examined vaginally more than 4 times (p=0.03) and those who delivered by caesarean section (p=0.02).

Conclusion and Recommendations: Out of ten women with clinical puerperal sepsis, one has laboratory confirmed blood stream infection and was predominantly due to Staphylococcus aureus. Routine culture and drug susceptibility testing should be maintained in these hospitals so as to guide specific management owing to high antimicrobial resistance.