The microbial pattern and antibiotic sensitivity in patients presenting with premature rupture of Membranesat Kitui County Hospital.

Abstract

Premature rupture of membranes (PROM) is the spontaneous rupture of the membranes anytime beyond 28 weeks of pregnancy but before onset of labor. When it occurs before 37 weeks of pregnancy are completed it istermed preterm PROM and occurs in 1%- 3% of all pregnancies. It is responsible for approximately one third of all preterm birth. The possible causes are many including, friability of membranes being increased due to lower genital tract infections. An estimated 15million babies are born preterm every year around the world and 1million die each year due to complication of preterm birth which include neonatal sepsis and asphyxia. Lower genital tract infections have been suggested as a cause of preterm birth. The common micro-organisms involved include,Bacterial vaginosis, trichomonasvaginalis and candida sp. At KNH the commonest micro-organism isolated was E.coli.(2). Treatment of these infections have been done using penicillin, Beta-lactams and macrolides (erythromycin) and it showed improvement by delaying but not preventing preterm birth. The choice of antibiotics should preferably be based on culture sensitivity. Objectives. The aim of the study was to determine the microbial pattern and antibiotic sensitivity in patients with PROM at Kitui County Hospital. Study area: The study was conducted in Kitui CountyHospital in Kitui County. The study design: This was a Cross-Sectional descriptive study. The study population: The study participants werepatients attending KituiCountyHospital antenatal clinic and admitted to òlabor ward with confirmed clinical diagnosis of premature rupture of membranes at 28th week to less than 37th week gestation of pregnancy. Data analysis: Datawas analyzed using SPSS software version 13. Results: A total of 112 questionnaires and laboratory results were analyzed. The mean age of the participants was 29.2 years. Majority, 50.8% of cases of PROM occurred after 32 weeks gestation. Candidaalbicans was the commonest microbe isolated accounting for 38.3% .The other organisms isolated were trichomonasvaginalis at 5.4%,staphylococcus aureus sp. at 3.6 % and staphylococcus albus at 5.4%. xiii The microbes were sensitive to Cefriaxone, Erythromycin and Ampiclox at 100% followed by Metronidazole and Dinamycin at 67%.Lastly Augmentine at 50%. Conclusion and recommendations: we recommend that Cefriaxone, Erythromycin and Ampiclox be first line in treatment of PROM where it’s not possible to do endocervicalswab for culture and antibiotic sensitivity.