Study of cases of puerperal sepsis, its socio-demographic factors, bacterial isolates, and antibiotic sensitivity pattern

J Family Med Prim Care. 2022 Sep;11(9):5155-5160. doi: 10.4103/jfmpc.jfmpc_2419_21. Epub 2022 Oct 14.

Abstract

Objective: Due to the lack of resources for culture and antibiotic susceptibility testing in most underdeveloped countries, puerperal sepsis is treated empirically with a wide range of antibiotics. Empirical treatment, on the other hand, does not ensure treatment effectiveness and may even contribute to antibiotic resistance. So, we studied cases of puerperal sepsis, its socio-demographic factors, bacterial isolates, and antibiotic sensitivity in a tertiary health center.

Material and methods: This was a cross-sectional study conducted at the obstetrics and gynecology department of a tertiary health center in India from April 2019 to September 2020. During this time, all patients with sepsis who met the criteria for inclusion were included. After granting an informed written consent, the subjects were registered on a pre-designed proforma.

Results: There were 2,049 obstetrical admissions throughout this period, with 106 (5.1%) of these having puerperal sepsis. The majority of these women (58.7%) were between the ages of 21 and 30, were multiparous (96.5%), and unbooked. Fever 104 (98.1%) was the most prevalent clinical characteristic, whereas wound gape was the most common consequence (47.1%). Klebsiella aerogens was the most common organism found in various cultures. Many organisms were shown to be multidrug-resistant and sensitive to gentamycin and amikacin.

Conclusion: Klebsiella aerogens wasthe most common cause of puerperal sepsis in this investigation. Because the causal agents of puerperal sepsis and their antibiotic sensitivity patterns change over time, positive blood culture and antibiotic susceptibility of the isolates are the best guides for selecting the optimum antimicrobial therapy for treating sepsis.

Keywords: Antibiotic susceptibility; bacterial resistance; multidrug-resistant; puerperal sepsis.