Antibiotic Drug Resistance in HIV Seropositive Pregnant Women

Background: Vaginal infections are often associated with a significant risk of morbidity especially in pregnant women. These infections if left untreated often result in a long-term sequelae and poses a higher adverse pregnancy outcome especially in immunocompromised women. While HIV infection has been reported to be a high risk of pathogenic bacterial colonization, the misuse of antibiotics is high among women in developing countries. Methodology and results: A high vaginal swab was collected from the posterior fornix from each pregnant women by the attending physician using sterile bivalve speculum and a cotton- tipped applicator. Each sample was cultured and identified using standard bacterlogical methods. Selected pathogens were thereafter tested for their sensitivity to 23 commonly prescribed antibiotics using the Kirby-Bauer method. Altogether, 1,156 bacterial isolates were cultured from high vaginal swabs of both 114 HIV seropositive and 126 HIV seronegative pregnant women, averaging 4.81 bacterial per subject each for both cohorts. S. aureus was seen as the single predominant isolate recovered from both groups. In addition, of the 22 S. aureus recovered from HIV infected women, 10 isolates were Methicillin resistant S. aureus (MRSA) and 12 Methicillin sensitive S aureus (MSSA), while, of the 25 S. aureus recovered from HIV seronegative women, 13 isolates were Methicillin resistant S. aureus (MRSA) and 12 Methicillin sensitive S aureus (MSSA). Other gram negative pathogens associated with lower genital infections were also studied. Conclusion: The incidence of multiple antibiotic resistance was high among isolates recovered from both cohorts, which is probably due to uncontrollable ease of access to these antibiotics in the environment where antibiotics restriction/policy is lacking. There is an urgent need for continuous monitoring, health education, drug abuse awareness and implementation of interventions to restrict antibiotic abuse especially among immunocompromised individuals in the study environment.