Vaginal colonization with antimicrobial-resistant bacteria among women in labor in central Uganda: prevalence and associated factors
Abstract Background According to WHO ( CISMAC. Centre for Intervention Science in Maternal and Child health), the antimicrobial resistant bacteria considered to be clinically most important for human health and earmarked for surveillance include extended-spectrum beta-lactamase (ESBL)-producing Ente...
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| Format: | Article |
| Language: | English |
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BMC
2021-02-01
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| Series: | Antimicrobial Resistance and Infection Control |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13756-021-00897-9 |
| _version_ | 1819297885155491840 |
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| author | Josephine Tumuhamye Hans Steinsland Freddie Bwanga James K. Tumwine Grace Ndeezi David Mukunya Olive Namugga Agnes Napyo Kasede Halvor Sommerfelt Victoria Nankabirwa |
| author_facet | Josephine Tumuhamye Hans Steinsland Freddie Bwanga James K. Tumwine Grace Ndeezi David Mukunya Olive Namugga Agnes Napyo Kasede Halvor Sommerfelt Victoria Nankabirwa |
| author_sort | Josephine Tumuhamye |
| collection | DOAJ |
| description | Abstract Background According to WHO ( CISMAC. Centre for Intervention Science in Maternal and Child health), the antimicrobial resistant bacteria considered to be clinically most important for human health and earmarked for surveillance include extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae, carbapenem-resistant bacteria, methicillin-resistant (MRSA) and, macrolide-lincosamide-streptogramin B -resistant vancomycin-resistant (VRSA) Staphylococcus aureus and vancomycin-resistant Enterococcus (VRE). If these bacteria are carried in the female genital tract, they may be transmitted to the neonate causing local or systemic neonatal infections that can be difficult to treat with conventionally available antimicrobials. In order to develop effective treatment strategies, there is need for updated information about the prevalence of colonization with important antimicrobial-resistant pathogens. Objective We sought to estimate the prevalence of vaginal colonization with potentially pathogenic and clinically important AMR bacteria among women in labour in Uganda and to identify factors associated with colonization. Methods We conducted a cross-sectional study among HIV-1 and HIV-2 negative women in labour at three primary health care facilities in Uganda. Drug susceptibility testing was done using the disk diffusion method on bacterial isolates cultured from vaginal swabs. We calculated the prevalence of colonization with potentially pathogenic and clinically important AMR bacteria, in addition to multidrug-resistant (MDR) bacteria, defined as bacteria resistant to antibiotics from ≥ 3 antibiotic classes. Results We found that 57 of the 1472 enrolled women (3.9% prevalence; 95% Confidence interval [CI] 3.0%, 5.1%) were colonized with ESBL-producing Enterobacteriaceace, 27 (1.8%; 95% CI 1.2%, 2.6%) were colonized with carbapenem-resistant Enterobacteriaceae, and 85 (5.8%; 95% CI 4.6%, 7.1%) were colonized with MRSA. The prevalence of colonization with MDR bacteria was high (750/1472; 50.9%; 95% CI 48.4%, 53.5%). Women who were ≥ 30 years of age had higher odds of being colonized with MDR bacteria compared to women aged 20–24 years (OR 1.6; 95% CI 1.1, 2.2). Conclusion Most of the women included in our study were vaginally colonized with potentially pathogenic MDR and other clinically important AMR bacteria. The high prevalence of colonization with these bacteria is likely to further increase the incidence of difficult-to-treat neonatal sepsis. |
| first_indexed | 2024-12-24T05:21:06Z |
| format | Article |
| id | doaj.art-45161ec04c404afa96921d4fc6b4fee4 |
| institution | Directory Open Access Journal |
| issn | 2047-2994 |
| language | English |
| last_indexed | 2024-12-24T05:21:06Z |
| publishDate | 2021-02-01 |
| publisher | BMC |
| record_format | Article |
| series | Antimicrobial Resistance and Infection Control |
| spelling | doaj.art-45161ec04c404afa96921d4fc6b4fee42022-12-21T17:13:27ZengBMCAntimicrobial Resistance and Infection Control2047-29942021-02-0110111110.1186/s13756-021-00897-9Vaginal colonization with antimicrobial-resistant bacteria among women in labor in central Uganda: prevalence and associated factorsJosephine Tumuhamye0Hans Steinsland1Freddie Bwanga2James K. Tumwine3Grace Ndeezi4David Mukunya5Olive Namugga6Agnes Napyo Kasede7Halvor Sommerfelt8Victoria Nankabirwa9Centre for Intervention Science for Maternal and Child Health, Department of Global Public Health and Primary Care, University of BergenCentre for Intervention Science for Maternal and Child Health, Department of Global Public Health and Primary Care, University of BergenDepartment of Medical Microbiology, Makerere University College of Health SciencesDepartment of Paediatric and Child Health, Makerere University College of Health SciencesDepartment of Paediatric and Child Health, Makerere University College of Health SciencesCentre for International Health, Department of Global Public Health and Primary Care, University of BergenCentre for International Health, Department of Global Public Health and Primary Care, University of BergenCentre for International Health, Department of Global Public Health and Primary Care, University of BergenCentre for International Health, Department of Global Public Health and Primary Care, University of BergenCentre for International Health, Department of Global Public Health and Primary Care, University of BergenAbstract Background According to WHO ( CISMAC. Centre for Intervention Science in Maternal and Child health), the antimicrobial resistant bacteria considered to be clinically most important for human health and earmarked for surveillance include extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae, carbapenem-resistant bacteria, methicillin-resistant (MRSA) and, macrolide-lincosamide-streptogramin B -resistant vancomycin-resistant (VRSA) Staphylococcus aureus and vancomycin-resistant Enterococcus (VRE). If these bacteria are carried in the female genital tract, they may be transmitted to the neonate causing local or systemic neonatal infections that can be difficult to treat with conventionally available antimicrobials. In order to develop effective treatment strategies, there is need for updated information about the prevalence of colonization with important antimicrobial-resistant pathogens. Objective We sought to estimate the prevalence of vaginal colonization with potentially pathogenic and clinically important AMR bacteria among women in labour in Uganda and to identify factors associated with colonization. Methods We conducted a cross-sectional study among HIV-1 and HIV-2 negative women in labour at three primary health care facilities in Uganda. Drug susceptibility testing was done using the disk diffusion method on bacterial isolates cultured from vaginal swabs. We calculated the prevalence of colonization with potentially pathogenic and clinically important AMR bacteria, in addition to multidrug-resistant (MDR) bacteria, defined as bacteria resistant to antibiotics from ≥ 3 antibiotic classes. Results We found that 57 of the 1472 enrolled women (3.9% prevalence; 95% Confidence interval [CI] 3.0%, 5.1%) were colonized with ESBL-producing Enterobacteriaceace, 27 (1.8%; 95% CI 1.2%, 2.6%) were colonized with carbapenem-resistant Enterobacteriaceae, and 85 (5.8%; 95% CI 4.6%, 7.1%) were colonized with MRSA. The prevalence of colonization with MDR bacteria was high (750/1472; 50.9%; 95% CI 48.4%, 53.5%). Women who were ≥ 30 years of age had higher odds of being colonized with MDR bacteria compared to women aged 20–24 years (OR 1.6; 95% CI 1.1, 2.2). Conclusion Most of the women included in our study were vaginally colonized with potentially pathogenic MDR and other clinically important AMR bacteria. The high prevalence of colonization with these bacteria is likely to further increase the incidence of difficult-to-treat neonatal sepsis.https://doi.org/10.1186/s13756-021-00897-9Antimicrobial resistanceMultidrug resistanceMDRESBLMRSAMLSB |
| spellingShingle | Josephine Tumuhamye Hans Steinsland Freddie Bwanga James K. Tumwine Grace Ndeezi David Mukunya Olive Namugga Agnes Napyo Kasede Halvor Sommerfelt Victoria Nankabirwa Vaginal colonization with antimicrobial-resistant bacteria among women in labor in central Uganda: prevalence and associated factors Antimicrobial Resistance and Infection Control Antimicrobial resistance Multidrug resistance MDR ESBL MRSA MLSB |
| title | Vaginal colonization with antimicrobial-resistant bacteria among women in labor in central Uganda: prevalence and associated factors |
| title_full | Vaginal colonization with antimicrobial-resistant bacteria among women in labor in central Uganda: prevalence and associated factors |
| title_fullStr | Vaginal colonization with antimicrobial-resistant bacteria among women in labor in central Uganda: prevalence and associated factors |
| title_full_unstemmed | Vaginal colonization with antimicrobial-resistant bacteria among women in labor in central Uganda: prevalence and associated factors |
| title_short | Vaginal colonization with antimicrobial-resistant bacteria among women in labor in central Uganda: prevalence and associated factors |
| title_sort | vaginal colonization with antimicrobial resistant bacteria among women in labor in central uganda prevalence and associated factors |
| topic | Antimicrobial resistance Multidrug resistance MDR ESBL MRSA MLSB |
| url | https://doi.org/10.1186/s13756-021-00897-9 |
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