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Updated: Aug 17, 2025
A Neonatal Imaging Model of Gram-Negative Bacterial Sepsis
Published on: August 12, 2020
Study of cases of puerperal sepsis, its socio-demographic factors, bacterial isolates, and antibiotic sensitivity
Preeti Singh1, Sarita Tirkey1, Kiran Trivedi1
1Department of Obstetrics and Gynecology, Rajendra Institute of Medical Sciences (RIMS), Ranchi, Jharkhand, India.
Insights
Puerperal sepsis is often treated empirically, but this study identified Klebsiella aerogens as a common cause. Antibiotic susceptibility testing is crucial for effective treatment and combating resistance.
Area of Science:
- Obstetrics and Gynecology
- Infectious Diseases
- Microbiology
Background:
- Puerperal sepsis is a significant cause of maternal morbidity and mortality, particularly in resource-limited settings.
- Empirical antibiotic treatment for puerperal sepsis lacks efficacy and contributes to antimicrobial resistance.
- Understanding local etiological agents and their antibiotic susceptibility is vital for effective management.
Purpose of the Study:
- To investigate the socio-demographic factors, bacterial isolates, and antibiotic sensitivity patterns of puerperal sepsis.
- To provide data for optimizing empirical antibiotic therapy in a tertiary healthcare setting.
Main Methods:
- A cross-sectional study was conducted from April 2019 to September 2020.
- 106 patients with puerperal sepsis were included after meeting inclusion criteria.
- Data on socio-demographics, clinical presentation, and microbial isolates were collected.
Main Results:
- Puerperal sepsis occurred in 5.1% of obstetrical admissions.
- The majority of affected women were aged 21-30, multiparous, and unbooked.
- Klebsiella aerogens was the most common isolate, with many showing multidrug resistance but sensitivity to gentamycin and amikacin.
Conclusions:
- Klebsiella aerogens is a primary cause of puerperal sepsis in this region.
- Positive blood cultures and antibiotic susceptibility testing are essential for guiding optimal antimicrobial therapy.
- Tailoring treatment based on local resistance patterns can improve outcomes and reduce resistance.
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.
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