Risk factors and microbial isolates of puerperal sepsis at the University of Maiduguri Teaching Hospital, Maiduguri, North-eastern Nigeria
Department of Obstetrics and Gynaecology, University of Maiduguri Teaching Hospital, P.M.B. 1414, Maiduguri, Nigeria. Archives of Gynecology
(Impact Factor: 1.36).
09/2011; 285(4):913-7. DOI: 10.1007/s00404-011-2078-4
To determine the risk factors and microbial isolates of puerperal sepsis.
A 12 year retrospective review of patients with puerperal sepsis from January 1999 to December 2010 at the University of Maiduguri Teaching Hospital (UMTH) was conducted. Information on socio-demographic characteristics, clinical presentations, place and mode of delivery and microorganism isolated from the endocervical swabs was collected and analysed. Comparison was also made with the other women that delivered during the period of study.
The incidence of puerperal sepsis was 0.78%. Majority (88.0%) of the patients were unbooked, 59.1% delivered at home and 23.1% delivered in other peripheral hospitals. The major risk factors for developing puerperal sepsis were unbooked status, home delivery, perineal trauma, caesarean section (C/S) and maternal age <24 years with OR of 56.60, 39.25, 8.52, 4.99 and 1.32, respectively. The commonest microorganism isolated were Staphylococcus aureus and Escherichia coli seen in 35.4 and 20.9%, respectively. Streptococcus species was found in 6.9%, while 20.3% had polymicrobials isolated.
Puerperal sepsis continues to present a significant risk of maternal mortality in developing countries. The risk factors are unbooked women, home delivery, perineal trauma, caesarean section and maternal age <24 years. S. aureus and E. coli are the commonest isolated organisms. There is a need to enlighten the populace on the need for booking, skilled attendant at delivery and hospital delivery under aseptic conditions.
Available from: Nicole M Gilbert
- "S aureus is an important peri-natal pathogen in many areas of the developing world. For example, in Nigeria, it is both the leading cause of early onset neonatal sepsis50 and the leading cause of maternal sepsis in childbirth.51 In fact, the microbiological profiles of the causes of maternal and neonatal sepsis around the time of birth in Nigeria are remarkably similar to the causes of maternal UTI (Figure 2). "
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ABSTRACT: The urinary tract is a common site of infection in humans. During pregnancy, urinary tract infection (UTI) is associated with increased risks of maternal and neonatal morbidity and mortality, even when the infection is asymptomatic. By mapping available rates of UTI in pregnancy across different populations, we emphasize this as a problem of global significance. Many countries with high rates of preterm birth and neonatal mortality also have rates of UTI in pregnancy that exceed rates seen in more developed countries. A global analysis of the etiologies of UTI revealed familiar culprits as well as emerging threats. Screening and treatment of UTI have improved birth outcomes in several more developed countries and would likely improve maternal and neonatal health worldwide. However, challenges of implementation in resource-poor settings must be overcome. We review the nature of the barriers occurring at each step of the screening and treatment pipeline and highlight steps necessary to overcome these obstacles. It is our hope that the information compiled here will increase awareness of the global significance of UTI in maternal and neonatal health and embolden governments, nongovernmental organizations, and researchers to do their part to make urine screening and UTI treatment a reality for all pregnant women.
09/2013; 2(5):59-69. DOI:10.7453/gahmj.2013.061
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ABSTRACT: Background: Increasingly, women in rural areas in Sudan reported to hospital with puerperal sepsis. Aims: This study was design to identify the common pathogens causing puerperal sepsis and their susceptibility to current antibiotics. Materials and Methods: We prospectively studied 170 women from January 2011 through December 2012 who attended Hussein Mustafa Hospital for Obstetrics and Gynecology at Gadarif State, Sudan. We included patients if they met the criteria proposed by the World Health Organization (WHO) for definition of puerperal sepsis. Results: Out of the 170 patients, 124 (72.9%) were pathogen-positive samples. Out of 124 positive isolates, aerobes were the predominant isolates 77 (62.1%) which included Staphylococcus aureus 49 (39.5%), Staphylococcus epidermidis 7(5.6%), and Listeria monocytogenes 21 (16.9%). The anaerobe isolates were Clostridium perfringens 34 (27.4%) and Enterobactor cloacae 13 (10.5%). Standard biochemical test were for bacterial isolation. Higher rate of infections followed vaginal delivery compared to Cesarean section, 121 (97.6%) and 3 (2.5%), respectively. All strains of Staph were sensitive to vancomycin, gentamicin, and ceftriaxone. C. perfringens were sensitive to ceftriaxone, penicillin, vancomycin, and metronidazole, while E. cloacae was sensitive to gentamicin and ceftriaxone. Conclusion: In this study, the main bacteriological isolates were S. aureus, S. epidermidis, L. monocytogenes, C. perfringens, and E. cloacae. Despite the limited resources in the developing countries, treatment based on cultures remains the only solution to reduce maternal morbidity and mortality rates following puerperal sepsis.
Annals of Tropical Medicine and Public Health 07/2013; 6(4):460. DOI:10.4103/1755-6783.127801
Available from: Amanda Nascimento
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The present study analyzed the effects of lipopolysaccharide (LPS) on maternal behavior during lactation and possible correlations with changes in emotional and immune responses in offspring.
Lactating rats received 100 μg/kg LPS, and the control group received saline solution on lactation day (LD) 3. Maternal general activity and maternal behavior were observed on LD5 (i.e. the day that the peak of fever occurred). In male pups, hematological parameters and ultrasonic vocalizations (USVs) were assessed on LD5. At weaning, an additional dose of LPS (50 µg/kg, i.p.) was administered in male pups, and open-field behavior, oxidative burst and phagocytosis were evaluated.
A reduction in the time in which dams retrieved the pups was observed, whereas no effects on maternal aggressive behavior were found. On LD5, a reduction of the frequency of USVs was observed in pups, but no signs of inflammation were found. At weaning, an increase in immune system activity was observed, but no differences in open-field behavior were found.
These results indicate that inflammation in lactating mothers disrupted mother/pup interactions and may have produced short- and long-term effects on pup behavior as well as biological pathways that modulate inflammatory responses to bacterial endotoxin challenge in pups.
NeuroImmunoModulation 08/2014; 22(4). DOI:10.1159/000363350 · 1.88 Impact Factor
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