ABSTRACT:
Background: Premature rupture of fetal membranes (PROM) occurs in 10% of all pregnancies globally, of which 4.2% are from Africa. At Bugando Medical Centre (BMC) 11% of admission in the year 2013 were due to PRO. Despite PROM being the huge problem in our setting; data on vaginal pathogenic bacteria colonization in women with PROM and those without PROM is not known. This study was done to determine if there is a difference between vaginal pathogenic bacteria colonization and susceptibility pattern among pregnant women with and without PROM.

Methods: a comparative study was carried out from August 2015 to March 2016. A total of 350 pregnant women from BMC, Seko Toure, Buzuruga health center and Nyamagana district hospital were enrolled, 175 presenting with PROM and 175 without PROM. High vaginal swabs were taken to investigate the presence of pathogenic bacteria and their susceptibility pattern.

Results: pregnant women with PRO had significantly higher media age (p=0.026). Majority of women with PROM were from urban areas with a significant proportion of multigravida. Only gestational age at booking was comparable between two groups. Pregnant women with PROM were more 31(17.7%) 95% CI [12-23] P<0.001. E. coli was the commonest vagina pathogenic bacteria detected 51(47%). Resistance rates was, meropenem 1.5%, ciprofloxacin 8.4%, ceftazidime 1.2%and ampicillin 98.4% among isolates from pregnant women with PROM respectively. Only age was found to be associated with pathogenic bacteria colonization in both groups. Increase in age was significantly associated with pathogenic bacteria colonization in women without PROM (P=0.046) while it was protective in women with PROM (P=0.015).

Conclusion: pregnant women with PROM are more colonized by vaginal pathogenic bacteria than those without PROM. E. coli is the predominant vaginal pathogenic bacteria colonizing pregnant women. Pathogenic bacteria colonizing pregnant women were highly resistant to ampicillin. Thus is a need to review the guidelines regarding antibiotic prophylaxis in women with PROM in our setting targeting gram negative bacteria.