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BACTERIOLOGICAL PROFILE AND SENSITIVITY PATTERN OF SEPTIC ABORTION
Abstract
Objective: The study aims to determine the bacteriological profile and sensitivity pattern of endocervical isolates in septic abortion patients at the Lagos Island Maternity Hospital, with a view of recommending appropriate 1st-line antibiotic regimen for the management of Septic abortion cases.
Design: This was be a prospective cross sectional study.
Materials and Methods: A standard questionnaire was administered to a total of 234 consenting patients (with signs and symptoms suggestive of septic abortion), who were recruited for the study between 1st February 2011 and 31st January, 2012. Endocervical swabs obtained before commencement of antibiotics were transported in peptone broth to the laboratory; isolates were identified by standard microbiology techniques and were subjected to antibiotic sensitivity tests.
Results: 46.2% of the patients were 30 years and above, 34.6% were petty traders and 55.6% had up to secondary education. 68.4% were married; 41.4% have had 1 or 2 previous abortions, 71.3% of the abortions were in the 1st trimester, 59.7% presented more than 7 days after procuring abortion. 46.5% had abortion done in hospitals (especially Private Hospitals) and 49.1% were performed by nurses. 70.8% had dilation and curettage or MVA done. Only 11% of all the patients were using contraceptives before index abortion and condom was the commonest method. Of the 234 endocervical specimens, 210 yielded significant growth of bacterial pathogens; 8 revealed no growth, 10 had mixed growth and 6 were viewed as contaminants.
E s c h e ric hia c oli was the most predominant organism isolated, while other isolates were S t a p h ylo c o c c u s a u r e u s , P s e u d o m o n a s a e r o gin o s a , E n t e r o b a c t e r a g glo m e r a n s , Kle b siella pneumoniae, Proteus mirabilis, Morgane lla morganni, Pseudomonas stuartii and Staphylococcus epidermidis. Levofloxacin was found to be the most effective antibiotic agent.
Conclusion: Endocervical isolates from septic abortion patients were polymicrobial in nature. Escherichia coli was the commonest organism isolated. Levofloxacin was the most effective antibiotic. Levofloxacin is hereby recommended as 1st-line drug regimen.
