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Tropical Journal of Obstetrics and Gynaecology

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Risk factors and antibiogram of organisms causing puerperal sepsis in a tertiary health facility in Nigeria.

CN Ononuju, TK Nyengidiki, HAA Ugboma, G Bassey

Abstract


Background: Puerperal sepsis is a common pregnancy related complication and is one of the leading causes of maternal morbidity and mortality in Sub Saharan Africa. There is paucity of regional data on the antibiogram and risk factors associated with this condition,
Aim: To determine the risk factors, aetiological organisms and antibiogram pauems in patients with puerperal sepsis at a Universi ty Teaching Hospital in Nigeria.
Method: A descriptive cross sectional study of patients who presented with puerperal sepsis at the University of Port Harcourt Teaching Hospital. Relevant biodata, pregnancy history types of organisms isolated from the endocervical swabs and their antibiogram were collated into a pre-structured proforma, Statistical analysis was done using statistical software SPSS for windows' version 19.0. Chi square test was used to explore the association of risk factors with P value <0,05 at 95% confidence interval.
Result: The incidence of puerperal sepsis was 9.34%. The mean age of the women was 27 ± 5 years. There was a strong association between unbooked status, emergency caesarean section, labour initially monitored outside the health facility and prolonged labour with puerperal sepsis (p=0.00); OR (68.60. 166.79. 102.73 and 3774) respectively. The commonest microorganism isolated in this study was Klebsiella species (57.7%), which were highly susceptible to ceftriaxone, eiftazidime. ciprofloxacin ofloxacin and gentamycin.
Conclusion: Thc risk of puerperal sepsis is increased in the unbooked patient during prolonged labour during emergeney caesarean section and unsupervised labour. The third generation cephalosporin and quinolones (in the absence of breastfeeding) were identified as the choice of regimen for empirical treatment of puerperal sepsis pending the availability of the endocervical swab sensitivity results.

Keywords: puerperal sepsis antibiogrum. risk factors. UPTH




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