The microbial pattern associated with preterm premature rupture of membranes as seen at Muhimbili National Hospital

Abstract

Preterm Premature Rupture of Membranes (PPROM) affects about 3% of pregnancies

worldwide. It is associated with significant maternal, fetal and neonatal complications.

Previous studies in Muhimbili National Hospital had shown only the prevalence of

PPROM. In MNH there is no data to show the microbial pattern of PPROM which is

important in the management of patients with PPROM. This study sought to address this

gap.

Objectives: To describe microbial pattern associated with preterm premature rupture of

membranes and their antimicrobial sensitivity pattern.

Stndy Population: Pregnant women admiued in the labour ward with PPROM and

PROM and not in labor.

8Wdy design; A descriptive cross -sectional study

Methods:' A structured questionnaire was used to collect Information on socio-economic

status and obstetric characteristics. Endocervical and high vaginal swabs were collected

toisolate micro organisms present in the genital tract Cervical smears were gram stained

nd evaluated microscopically. Sensitivity patterns were also investigated

Resulh: A total of 110 cases of PPROM and 220 of PROM were analyzed Pathogens wereisclatedin 50/110(45.5%) in patients with PPROM compared to only 11.5% isolated from patients with PROM. The common microbes isolated in PPROM were

E`" ( `O]1. (30o]o), Klebsiella (24010), Candiasi (10%) Staphylococcus aureus (4%)

Trichomonaas vaginall's (14%), Neisseria gonorrheae and Staphyloococcus aureus were not

isolated in patients with PROM, This difference was statistically significant. Bacterial

Vaginosis was isolated in the PPROM group was 36% while in the PROM group it was

23%.Ceftriaxone and Gentamicin were found to have appropriate susceptibility pattern.

Common isolates were found to be resistant to Ampicilin, Chloramphenicol.

Conclusion; It has been shown from this study that some pathogens were associated with

PPROM and PROM and that Ceftriaxone and Gentamicin were the antibiotics with

appropriate sensitivity. It is emphasized that women with PPROM should have

endocervical swabs taken so as to know the anti microbial sensitivity.