Document Type : Original Article
Authors
1
Microbiology Department-Egyptian Drug Authorization (EDA), Giza, Egypt.
2
Department of Microbiology and Immunology, Faculty of Pharmacy (Boys), Al-Azhar University Cairo, Egypt
3
Department of Obstetrics and Gynecology, Faculty of Medicine (Girls), Al-Azhar University, Cairo, Egypt.
4
Department of Microbiology and Immunology, Faculty of Pharmacy (Boys), Al-Azhar University Cairo, Egypt.
Abstract
Microbial infection with some species of microorganisms during pregnancy can affect the health of pregnant women, resulting in high morbidity and complication rates during pregnancy. The aim of this study was to investigate the prevalence of microbial infection in pregnant women according to trimesters and to determine whether the presence of abnormal vaginal colonization is associated with a higher risk of miscarriage, preterm labour (PTL), and premature rupture of membranes (PROM). This study was carried out on 200 pregnant women between 20 and 35 years old with obstetric complications. The clinical specimens were collected and cultured on different culture media. The isolates were subcultured on specific culture media and subjected to identification using morphological staining, cultural characteristics and biochemical tests. The total number of microorganisms isolated was 359, Gram-negative 203 (56.6%), followed by 116 Gram-positive bacteria (32.3%), and 40 fungal isolates (11.1%). The highest isolation rate of Gram negative bacteria was E. coli (27.3%) as shown in 1st trimester (10.3%), 2nd trimester (5%) and 3rd trimester (12%), while the lowest isolation rate was C. diversus (0.56%). Whereas the highest isolation rate of Gram positive bacteria was E. faecalis (17.8%) as shown in 1st trimester (6.4%), 2nd trimester (4.46%) and 3rd trimester (6.96%), while the lowest isolation rate was S. pyogenes (0.56%) and K. kristinae (0.28%). The highest isolation rate of fungal isolates was C. ablicans (7.8%) as shown in both 1st trimester and 2nd trimester (2.23%, each) and 3rd trimester (3.34%), while the lowest isolation rate was C. tropicalis (0.28%) and C. parapsilosis (0.28%). Moreover, all the isolates were subjected to an antimicrobial susceptibility test conducted using modified Kirby-Bauer disk diffusion method. The isolates showed different antimicrobial susceptibility patterns to the tested antimicrobial agents with various percentages. All the isolates of N. gonorrhoeae were resistant to tested antibiotics while all the isolates of C. diversus and S. agalactiae were sensitive to the tested antimicrobial agents. Analysis of phenotypic resistance of beta lactam antibiotics showed that 41 (21.93%) out of 187 isolates of Gram negative bacteria were positive for extended-spectrum β-lactamases (ESBls) production, the highest incidence was 25 (13.37%) isolates of E. coli, while the lowest incidence was P. mirabilis (one isolate). Whereas 19 (10.16%) out of 187 isolates were positive for AmpC synthesis, the highest frequency was 12 (6.4%) isolates of E. coli while the lowest frequency was one isolate of P. mirabilis. In addition, only 10 (5.3%) out of 187 isolates of Gram negative bacteria that represented 10 (29.4%) out of 34 P. aeruginosa isolates were positive for metallo-β-lactamases (MBLs) production. On the other hand, MBLs were not detected in E. coli, K. pneumoniae, C. diversus and P.mirabilis. In conclusion, a significant percentage (97%) of the studied pregnant participants with experienced obstetric complications had microbial colonization correlated to the different trimesters. In order to prevent complications associated to childbirth, routine laboratory examinations during pregnancy, such as urine cultures and vaginal swabs are advised to be carried out.
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