Background: Puerperal sepsis (PS) is one of the leading causes of preventable maternal morbidity and mortality. The World Health Organization (WHO) estimates PS causes 10% of maternal deaths in Africa. The present study was conducted because of limited data in Mwanza on endocervical bacterial pathogens, antibiotic susceptibility pattern and their associated risk factors.
Methodology: A cross-sectional analytical hospital based study which was been conducted from October 2017 to April 2018 involving 340 women with clinical features of PS. A structured pre-tested questionnaire was used to obtain socio-demographic, clinical and obstetric information from the participants. The endocervical swab was taken from women for culture and antimicrobial susceptibility testing. Data were analysed by STATA version 13 software.
Results: Of the 340 women with clinical features of PS 183 (53.8%) had positive culture result for endocervical swabs; with predominance of Escherichia coli, Acinetobacter spp., Klebsiella pneumoniae and Staphylococcus aureus. Majority of these bacterial pathogens were multidrug resistant. Risk factors for laboratory confirmed PS were primipara, premature rupture of membrane, prolonged labor duration, and more than four per vaginal examinations.
Conclusions and recommendations: Approximately half of women with clinical features of PS had laboratory confirmed puerperal sepsis caused by multidrug resistant bacteria pathogens, calling for laboratory guided patients management. The risk factors identified should be taken as priority targets groups preventive measures against PS in Mwanza region.
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