Prevalence, Spectrum and Antibiotic Susceptibility of Bacterial and Candida Colonization between the 21st and 33rd Week of Gestation in Women with PPROM – 5 Yearsʼ Experience in 1 Perinatal Center

Abstract

Objective: The aim of this study was to evaluate the prevalence, spectrum and antibiotic susceptibility of bacterial and Candida colonization of the vagina between the 21st and the 33rd week of gestation in women who had preterm premature rupture of membranes (PPROM). Study design: High vaginal swabs from 245 subjects with PPROM were analyzed in a retrospective cohort study using cultivation-dependent methods. Patients were additionally divided into two groups: women with PPROM between the 21st and 27th week of gestation (group A) and women with PPROM between the 28th and 33rd week of gestation (group B). A subgroup analysis comparing the two groups was done. Results: The prevalence of pathological bacterial colonization was similar in both study groups (40.8 vs. 41.4 %; p > 0.05), however, a difference in antibiotic susceptibility was noted, which did not reach statistical significance (resistance to ampicillin 71.4 vs. 52.5 %; cefuroxime 9.5 vs. 11.7 %; gentamicin 28.6 vs. 16.4 %; ciprofloxacin 5.0 vs. 5.4 %). In group A there was a statistically significant lower rate of Candida colonization (11.1 vs. 24.3 %; p = 0.04). Conclusion: In patients with early PPROM, the rate of Candida colonization (group A) is lower and there are indications of a difference in antibiotic susceptibility of the colonizing bacteria depending on gestational age. Larger study groups are required to confirm these preliminary results.

Zusammenfassung

Einleitung: Ziel dieser Studie ist die Untersuchung von Prävalenz, Spektrum und Antibiotikaresistenz der Bakterien- und Candida-Kolonisation der Scheide nach vorzeitigem Blasensprung in der 21. bis zum Abschluss der 34. Schwangerschaftswoche. Material und Methode: Hohe vaginale Abstriche von 245 Schwangeren mit vorzeitigem Blasensprung wurden retrospektiv mit Kultivierung analysiert. Eine Subgruppe von Schwangeren in der 21. bis zum Abschluss der 27. Schwangerschaftswoche (Gruppe A) wurde mit Schwangeren in der 28. bis zum Abschluss der 33. Schwangerschaftswoche verglichen. Ergebnisse: Die Prävalenz bakterieller Kolonisation war in beiden Gruppen in vergleichbarer Häufigkeit vorhanden (40,8 vs. 41,4 %, p > 0,05). Es zeigte sich jedoch eine unterschiedliche Antibiotikaresistenz in beiden Gruppen; der Unterschied war statistisch nicht signifikant (Resistenz gegen: Ampicillin 71,4 vs. 52,5 %; Cefuroxim 9,5 vs. 11,7 %; Gentamicin 28,6 vs. 16,4 %; Ciprofloxacin 5,0 vs. 5,4 %). In Gruppe A zeigte sich eine statistisch signifikant niedrigere Candida-Kolonisation (11,1 vs. 24,3 %; p = 0,04). Schlussfolgerung: Schwangere mit sehr frühem vorzeitigem Blasensprung haben eine niedrigere Candida-Kolonisation und möglicherweise eine andere Antibiotikaresistenz abhängig vom Schwangerschaftsalter. Größere Studien sind notwendig, um diese vorläufigen Ergebnisse zu bestätigen.

Key words

preterm premature rupture of membrane - antibiotic susceptibility - bacterial and Candida colonization - prevalence

Schlüsselwörter

vorzeitiger Blasensprung - Antibiotikaresistenz - Bacteria- und Candida-Kolonisation - Prävalenz

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