Analytical study on Uro-genital infections and their antibiotic response status in preterm and term labor patients in a tertiary care institute in Chennai

Abstract

Delivery occurring prior 37 weeks of gestation account to the maximum incidence of Neonatal morbidity and mortality in India. Amongst the various factors that trigger Preterm birth presence of infections in the lower reproductive tract and the female urinary tract constitute to be a common cause. Such infections release noxious toxic radicals that not only initiate premature uterine contractions but also cause damage to the amniotic membrane resulting in pre-labor rupture of the membranes. The objective of this study was to evaluate the various vaginal micro- organisms present and their antibiotic response in women presenting with preterm labor and compare them with those in women who deliver after 37 weeks of gestation.A sample size of 100 women who presented with preterm labor pains were selected and were compared with 100 women who delivered beyond 37 weeks of gestation with matched demographic and physical parameters. The study was done in Institute of Obstetrics and Gynecology, Egmore, a tertiary care institute at Chennai, South India. High vaginal swab culture sensitivity was done along with mid-stream clean catch urine culture sensitivity for women who reported with labor pains prior to 37 completed weeks of gestation. The type of micro-organisms was also compared with those of women who had term delivery. The study revealed that genital infections were twice as more common in women with preterm labor when compared with women with term delivery. It was also evident that preterm labor was more common in multiparas as against primiparas and the age group of common occurrence was around 20-25 years. High vaginal swab culture was positive 52% and urinary pathogens were demonstrated in 66% of the study group women. The risk was high in women belonging to the low socioeconomic group and in women with short inter pregnancy interval. The most common organism isolated in the vaginal tract was Staphylococcus aureus followed by E. coli and Pseudomonas and the commonpathogen in urine was E. coli. The organisms were sensitive to Linezolid, Amikacin and Vancomycin and resistant to cephalosporins and ciprofloxacin.