Microbial Flora and Antimicrobial Susceptibility of Microorganisms from Asymptomatic Contraceptive Users and Non-Users of Reproductive Age

Abstract

Introduction: The use of contraceptives is important in preventing unplanned pregnancy and sexually transmitted diseases. However, the use of various contraceptive methods could expose women to microbial infections. Aim: To investigate the antimicrobial susceptibility of microbial flora from vaginal swab of asymptomatic women using different contraceptive methods. Materials and Methods: In this study, high vaginal swab samples were collected from sexually active 406 women between 20 and 45 years of age. Women who were nonspecific user of methods were considered as control group. All participating women had no history of antibiotic use since last 2 weeks from the study period as well as abstained from the same during the study period from June to December 2017. The use of contraceptives among different age groups was determined. The microbial flora of asymptomatic individuals were assessed by direct smear, microscopy examination, bacteriological and biochemical identification of the isolated microorganisms and their susceptibility were carried out on the samples collected. All information collected was compiled and data were analysed using SPSS Software programme. Results: In this study, 39.4% of the population (n=406) were combined hormonal users. While the percentage of the Intrauterine Device (IUD) users was 27.1% and those of the condom users was 21.2%, the non-specific users were 12.3% of the sampled population. Of the women using different contraceptives, 8.1% (29) women using combined hormonal contraceptives, and 2.53% (9) barrier users, 1.97% IUDs users and only 10% of the 50 women in the control groups had bacterial infection. On the other hand, the distribution of fungal strains isolated from contraceptive users showed that 16.01% (57) IUDs users, 5.7% (23) combined hormonal users, 5.06% (18) barrier users and only 16.0% (8) of the women (n=50) in the control group had fungal infection. The antimicrobial assay showed that more than 90% of P. mirabilis, K. oxytoca, E. coli, Group B beta-haemolytic streptococci and S. aureus were susceptible to ciprofloxacin, ofloxacin, P. mirabilis (50%), K. oxytoca (95%), E. coli (96%), H. streptococci (80%) and S. aureus (94%) were susceptible to nitrofurantoin. However, these isolates were highly resistant to ceftazidime, gentamycin, kanamycin, tetracycline, cloxacillin, augmentin, ampicillin and amoxicillin. On the other hand, 80% of the fungal isolates were susceptible to ketoconazole, nystatin (75%), clotrimazole (65%) and fluconazole (60%) but were all resistant to griseofulvin. Conclusion: This study shows that more strains of bacteria and fungi were isolated from women in ages 31-35 years of women sampled and indicated that the most predominant isolates in asymptomatic individuals using contraceptives were highly resistant to most of the antibiotics used except ciprofloxacin, ofloxacin and nitrofurantoin to which they were highly susceptible.

Keywords

• antimicrobial activities
• multidrug resistant
• vaginal infections