尼日利亚一家教学医院早期早产自发性胎膜破裂妇女的微生物分离物和抗生素敏感性模式

R. Habib, A. Rabiu, Z. Muhammad, O. Abiodun
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摘要

背景:早产产前膜破裂(PPROM)是早产、产妇和早发新生儿脓毒症的重要危险因素。在资源贫乏的国家,需要对微生物分离株和抗生素敏感性模式进行研究。目的:了解早期PPROM患者的微生物分离株及抗生素敏感性。材料与方法:对60例有PPROM的孕妇与60例无PPROM的对照组进行比较研究。感兴趣的研究变量是社会人口学特征和招募时的胎龄,微生物分离物和抗生素敏感性模式。获得的数据以表格形式呈现,并以频率和百分比记录。定性变量和定量变量的比较分别采用X2检验和学生t检验。P值< 0.05认为差异有统计学意义。结果:除社会阶层(x2 = 11.659, P = 0.003)和订票状况(x2 = 53.494, P < 0.001)外,两组间社会人口学特征无显著相关。PPROM组和非PPROM组的阳性培养率分别为51例(85.0%)和9例(15.0%)。大肠杆菌18(30.0%)是PPROM组中最常见的分离菌。PPROM组检出沙眼衣原体抗原6例(10.0%)。对分离的微生物有极好的敏感性的抗生素是美罗培南、头孢他啶和哌拉西林。结论:生殖道感染与PPROM的发生有显著关系,大肠杆菌是最常见的分离微生物。静脉注射头孢曲松后口服头孢克肟符合国家儿童健康和人类发展研究所,母胎医学单位(NICHD-MFMU)作为PPROM预防性抗生素的选择标准。
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Microbial isolates and antibiotic sensitivity pattern among women with early preterm spontaneous prelabor rupture of fetal membranes in a Nigerian teaching hospital
Background: Preterm prelabor rupture of membranes (PPROM) is a significant risk factor for prematurity, maternal, and early-onset neonatal sepsis. A study of the microbial isolates and antibiotic sensitivity pattern is needed in a resource poor country. Objectives: To identify the microbial isolates and antibiotic sensitivity pattern of patients with early PPROM. Materials and Methods: It was a comparative study between 60 pregnant women who had PPROM and 60 matched controls without PPROM. Study variables of interest were sociodemographic characteristics and gestational age at recruitment, microbial isolates, and antibiotic sensitivity pattern. Data obtained were presented in tabular forms and recorded as frequencies and percentages. x2 and students' t – tests were used to compare qualitative and quantitative variables, respectively. Statistical significance was considered at P value < 0.05. Results: Sociodemographic characteristics did not show any significant association between the two groups except for social class (x2 = 11.659, P = 0.003) and booking status (x2 = 53.494, P < 0.001). Positive culture rate of 51 (85.0%) and 9 (15.0%) were found in the PPROM and non-PPROM groups, respectively. Escherichia coli 18 (30.0%) was the most frequently isolated organism in the PPROM group. Chlamydia trachomatis antigen was detected in six cases (10.0%) among the PPROM group. Antibiotics that had excellent sensitivity to the isolated organisms were meropenem, ceftazidime, and piperacillin. Conclusion: Genital tract infection was significantly related to the occurrence of PPROM and E. coli was the commonest microbial organism isolated. Intravenous ceftriaxone followed by oral cefixime met national institute of child health and human development, maternal-fetal medicine units (NICHD-MFMU) criteria for selection as prophylactic antibiotic in PPROM.
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