Prevalence, Spectrum and Antibiotic Susceptibility of Bacterial and Candida Colonization between the 21st and 33rd Week of Gestation in Women with PPROM - 5 Yearsʼ Experience in 1 Perinatal Center

Abstract

Introduction !In Europe the rate of preterm births is about 5 to 9 % of all births. However in the USA the preterm birth rate is even higher (12-13%) and the rates are increasing, despite a better knowledge of the risk factors involved [1]. This increase is partly due to rising numbers of medically indicated preterm births (for maternal or fetal indications) and to the increase in assisted reproductive technologies [1,27]. Children born preterm have a higher risk for major disabilities, such as cerebral palsy Abstract !Objective: The aim of this study was to evaluate the prevalence, spectrum and antibiotic susceptibility of bacterial and Candida colonization of the vagina between the 21st and the 33rd week of gestation in women who had preterm premature rupture of membranes (PPROM). Study design: High vaginal swabs from 245 subjects with PPROM were analyzed in a retrospective cohort study using cultivation-dependent methods. Patients were additionally divided into two groups: women with PPROM between the 21st and 27th week of gestation (group A) and women with PPROM between the 28th and 33rd week of gestation (group B). A subgroup analysis comparing the two groups was done. Results: The prevalence of pathological bacterial colonization was similar in both study groups (40.8 vs. 41.4 %; p > 0.05), however, a difference in antibiotic susceptibility was noted, which did not reach statistical significance (resistance to ampicillin 71.4 vs. 52.5 %; cefuroxime 9.5 vs. 11.7 %; gentamicin 28.6 vs. 16.4 %; ciprofloxacin 5.0 vs. 5.4 %). In group A there was a statistically significant lower rate of Candida colonization (11.1 vs. 24.3 %; p = 0.04). Conclusion: In patients with early PPROM, the rate of Candida colonization (group A) is lower and there are indications of a difference in antibiotic susceptibility of the colonizing bacteria depending on gestational age. Larger study groups are required to confirm these preliminary results. (40,8 vs. 41,4 %, p > 0,05). Es zeigte sich jedoch eine unterschiedliche Antibiotikaresistenz in beiden Gruppen; der Unterschied war statistisch nicht signifikant (Resistenz gegen: Ampicillin 71,4 vs. 52,5 %; Cefuroxim 9,5 vs. 11,7 %; Gentamicin 28,6 vs. 16,4 %; Ciprofloxacin 5,0 vs. 5,4 %). In Gruppe A zeigte sich eine statistisch signifikant niedrigere Candida-Kolonisation (11,1 vs. 24,3 %; p = 0,04 Zusammenfassung

Vaginal Microbial Colonization after Antibiotic Treatment in Women with Preterm Premature Rupture of Membranes: An Observational Cohort Study

“…Numerous studies have investigated the vaginal microbial colonization among individuals with pPROM in recent years [11][12][13][14], yielding diverse findings. Paramel Jayaprakash et al [12] observed a highly heterogeneous and unstable vaginal microbiome in pPROM patients.…”