SEPTICEMIA, ITS BACTERIAL ISOLATES, DRUG SUSCEPTIBILITY PATTERNS AND ASSOCIATED FACTORS AMONG SUSPECTED WOMEN ATTENDING DELIVERY AT DILCHORA HOSPITAL, DIRE DAWA, EASTERN ETHIOPIA

Abstract

Puerperal sepsis is a major cause of maternal morbidity and mortality and is usually within the first 42 days after child birth. It is the second cause of maternal morbidity and mortality in the resource poor countries. Maternal septicemia infection is related factors such as cesarean section, prolonged labor, socio economic status, multiple vaginal examinations multiple pregnancies. The aim of this study was to assess the prevalence of Septicemia, its Bacterial isolates drug susceptibility patterns and associated factors among suspected women attending delivery at Dil-chora referral hospital, Dire Dawa, Eastern Ethiopia from May 1 to July 30 /2016.The study employed hospital based cross sectional study design with a sample size of 441 women of the age group 17-49 years at Dil-chora hospital, Dire Dawa, Eastern Ethiopia from May to July 30 /2016. Socio-demographic and clinical data variables were collected using structured interview administered questionnaire. Blood was collected aseptically and inoculated aerobically for 48 hours. Inoculated blood was incubated on MacConkey and blood agar to isolate bacteria. Antimicrobial susceptibility pattern of isolated bacterial pathogens was determined by Kirby Bauer disc diffusion method and collected data was analyzed using SPSS version 16; Binary logistic regression was used to measure the association between dependent and independent variables and significant variables were further adjusted using multivariate analysis. P-value <0.05 was considered as level of significance. The prevalence of septicemia was 12.9 and Coagulase negative staphylococcus 28.1% was found to be the most frequent isolate followed by E.coli 22.8% while Pseudomonas aeruginosa 10.5% and Proteus spp 3.5%.. General rate of sensitivity pattern of bacterial isolates were 0-94%.They showed high level sensitivity for Ceftriaxone, Ciprofloxacin followed by Gentamycin. Multiple vaginal examination [p=0.001, AOR: 0.644, 95% CI: 0.503, 0.824] and multiple pregnancy [p=0.035, AOR: 0.797, 95% CI: 0.645, 0.984) were associated with the occurrence of sepsis. The prevalence of septicemia was 12.9%. Coagulase negative staphylococci and E.coli were the predominant isolated bacteria. Most of bacterial isolates were resistant against commonly used antibiotics such as Ampicillin, Amoxicillin and Tetracycline. Multiple vaginal examination and multiple pregnancies were associated with septicemia. Ciprofloxacin, gentamycin and erythromycin can be used as empirical therapy of septicaemia where antibiotic sensitivity test cannot be done .Establishing regional laboratory that regularly review the microbial isolates and their sensitivity pattern contribute in reducing the prevalence of septicemia. Multiple pregnancies were associated with septicemia awareness creation on doctors, mid wives and medical students about the related risk factors, symptoms, signs, investigation and treatment of sepsis has importance for recognition of the illness as this can reduce morbidity and mortality.