Antibiogram Profile and Resistance Patterns of Microflora from Vaginal Discharge in Reproductive-age Women at a Nigerian Teaching Hospital

Chizoba M. Enemchukwu; Christiana Nwabueze; Oluchi J. Osuala; Chinedu J. Ikem; Muodebe C. Nwokeji; Charles O. Nnadi

Authors

Chizoba M. Enemchukwu Department of Pharmaceutical Microbiology and Biotechnology, Faculty of Pharmacy, Madonna University Elele, 512101 Rivers State, Nigeria
Christiana Nwabueze Department of Pharmaceutical Microbiology and Biotechnology, Faculty of Pharmacy, Madonna University Elele, 512101 Rivers State, Nigeria
Oluchi J. Osuala Department of Pharmaceutical Microbiology and Biotechnology, Faculty of Pharmacy, Madonna University Elele, 512101 Rivers State, Nigeria
Chinedu J. Ikem Department of Pharmaceutical Microbiology and Biotechnology, David Umahi Federal University of Health Sciences, Uburu, 491101 Ebonyi State, Nigeria
Muodebe C. Nwokeji Department of Medical Microbiology, Faculty of Clinical Basic Sciences, Madonna University Elele, 512101 Rivers State, Nigeria
Charles O. Nnadi Department of Pharmaceutical and Medicinal Chemistry, Faculty of Pharmaceutical Sciences, University of Nigeria Nsukka, 410001, Nigeria

Keywords:

Antimicrobial Agents, Bacterial Vaginosis, Multi-Drug Resistance, Vaginal Discharge

Abstract

Background: The adult human vagina hosts a complex biota containing diverse communities of microorganisms. The occurrence of multi-drug-resistant strains of these microorganisms has persistently increased due to poor hygiene and misuse or abuse of antibiotics. The vaginal microflora may exhibit patterns of growth, biochemical expression, or response to the standard drugs which consequently lead to answer the complex questions of antimicrobial resistance.

Aim: The study aimed to quantify the susceptibility profile of microorganisms isolated from vaginal discharge and evaluate the minimum inhibitory concentration of diverse antimicrobial drugs.

Methods: Fifty vaginal swabs were collected from female students of Madonna University, Nigeria while two samples were collected each from a pregnant and a non-pregnant woman at the university’s tertiary care teaching hospital. The isolates were grown in selective media and identified through Gram-staining and biochemical physiology for identification. The Kirby-Bauer disc diffusion method was used for microbial susceptibility testing, and the agar dilution method was used to determine the minimum inhibitory concentration of commonly prescribed antibiotics at the teaching hospital.

Results: Sixty-eight microorganisms comprising 17 Gram-positive (Staphylococcus sp.) and 31 Gram-negative (Escherichia coli and others) bacteria and 20 fungi (Candida sp.) were isolated. The bacteria showed a high resistance (>80%) to amoxicillin, cefuroxime, and cefixime but were relatively susceptible (35–100%) to levofloxacin and ofloxacin. Cefepime showed high activity with a minimum inhibitory concentration range of 25–50 µg/mL against the studied bacteria. The isolated fungi were susceptible to amphotericin B (35–40%) but resistant (>85%) to other antifungal drugs tested.

Conclusion: The study suggests that bacterial vaginosis prevalence at the university could best be treated with ofloxacin (second generation- fluoroquinlone), levofloxacin (third generation- fluoroquinolone), and cefepime (fourth generation- cephalosporin) due to their greater sensitivity, while candidiasis could best be treated with amphotericin B (a pyolene).