Bacterial Colonization of Vagina in Indian Women During Labor and Its Association With Puerperal and Neonatal Sepsis: A Tertiary Hospital Study

Abstract

Objective The aim was to find the prevalence of colonization of vagina with aerobic bacteria among low-risk Indian women in active labor and its association with early-onset neonatal sepsis (EONS) and puerperal sepsis. Methods The study was conducted prospectively from October 2018 to March 2020 in a tertiary hospital in New Delhi, India. Low-risk pregnant women (N=920) in active labor with intact membranes were recruited. High vaginal swabs were collected, cultured by standard methods to detect aerobic bacteria. The primary outcomes were the development of puerperal sepsis and EONS. Results In a total of 920 low-risk subjects, vaginal colonization was found in 484 (52.6%), coagulase-negative Staphylococcus being the predominant colonizer (13.2%) followed by Escherichia coli (8.9%). Multigravida women were at 1.4 times higher risk of colonization than primigravida (odds ratio [OR] 1.399; 95% CI 1.064, 1.84). Women whose sample was collected at the first vaginal examination were at 0.34 times lower risk of colonization as compared to women with more than one vaginal examination (OR 0.34; 95% CI 0.241, 0.481). The incidence of colonization increased with progressive vaginal examinations (p<0.001). None of the colonized women and their neonates developed puerperal sepsis or EONS, respectively. Conclusion Vaginal colonization of aerobic bacteria in active labor is not associated with an increased risk of puerperal sepsis or EONS.

Puerperal sepsis: Bacterial profile, Antimicrobial susceptibility patterns and Associated factors at Asella Referral and Teaching Hospital, Central Ethiopia: Cross sectional study

“…The proportion of bacterial isolates from an endocervical swab was 89.4%, which is in line with the study done in Nigeria with a proportion of 82.7% [17] and Tanzania 90.5% [18]. However it was higher than the studies from Tanzania 43.6%, [12] India 52.6% [19], and Zimbabwe 68.2% [13]. Higher proportion was reported from Nigeria 99.2% [20].…”

Prevalence of Gram-negative Bacteria in Maternal Cervical Secretions: A Systematic Review and Meta-analysis

“…Escherichia coli was the most extensively analyzed gram-negative bacterial species; it was examined in 15 studies. 48,50,[54][55][56][57][58][59][60] Klebsiella pneumoniae was examined in 12. 48,50,[54][55][56][58][59][60][61][62] Pseudomonas spp.…”

“…48,50,[54][55][56][57][58][59][60] Klebsiella pneumoniae was examined in 12. 48,50,[54][55][56][58][59][60][61][62] Pseudomonas spp. in 7, 34,48,54,55,58,61 Enterobacter spp.…”

“…48,50,[54][55][56][58][59][60][61][62] Pseudomonas spp. in 7, 34,48,54,55,58,61 Enterobacter spp. in 4, 48,55,56,58 Acinetobacter spp.…”

The pathogenesis of prevalent aerobic bacteria in aerobic vaginitis and adverse pregnancy outcomes: a narrative review

“…A recent Indian study found that of the patients who presented with abnormal discharge, 15.0% were diagnosed with AV by culture, including infections with Escherichia coli ( E. coli , 7.5%), Staphylococcus aureus ( S. aureus , 4.5%), Klebsiella (2.0%), and Enterococcus species (1.0%) [ 8 ]. Another Indian study focused only on the isolation of aerobic bacteria in vaginal colonization in low-risk asymptomatic pregnant women with intact membranes who presented to a tertiary-level hospital for delivery; 52.6% of women had vaginal colonization with pathogenic aerobic bacteria, 13.2% of women yielded coagulase-negative S. aureus , and 8.9% of women had E. coli [ 9 ]. A Poland retrospective laboratory-based multi-centre study included patients with suspected vaginosis and clinical signs of infections and collected vaginal swabs.…”