Vaginal colonization with antimicrobial-resistant bacteria among women in labor in central Uganda :

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dc.contributor.authorTumuhamye, Josephine
dc.contributor.authorSteinsland, Hans
dc.contributor.authorBwanga, Freddie
dc.contributor.authorTumwine, James K.
dc.contributor.authorNdeezi, Grace
dc.contributor.authorMukunya, David
dc.contributor.authorNamugga, Olive
dc.contributor.authorKasede, Agnes Napyo
dc.contributor.authorSommerfelt, Halvor
dc.contributor.authorNankabirwa, Victoria
dc.date.accessioned2024-02-22T11:37:32Z
dc.date.available2024-02-22T11:37:32Z
dc.date.issued2021
dc.descriptionResearch article
dc.description.abstractBackground: 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 a 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 healthcare 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. Keywords: Antimicrobial resistance, Multidrug resistance, MDR, ESBL, MRSA, MLSB, Carbapenem-resistant bacteria, Vaginal colonization
dc.description.sponsorshipUniversity of Bergen ; Busitema University
dc.identifier.citationTumuhamye, J., Steinsland, H., Bwanga, F., Tumwine, J. K., Ndeezi, G., Mukunya, D., ... & Nankabirwa, V. (2021). Vaginal colonization with antimicrobial-resistant bacteria among women in labor in central Uganda: prevalence and associated factors. Antimicrobial Resistance & Infection Control, 10, 1-11.
dc.identifier.urihttps://doi.org/10.60682/254e-2977
dc.language.isoen
dc.publisherBMC
dc.titleVaginal colonization with antimicrobial-resistant bacteria among women in labor in central Uganda :
dc.title.alternativeprevalence and associated factors
dc.typeArticle
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