Healthcare associated infection after legal induced abortions in ukraine: results a multicenter study

Abstract

The aim: To determine trend of legal induced surgical abortion and to assess the frequency of infection complications after termination of pregnancy in Ukraine. Materials and methods: We conducted a prospective multicentre cohort study was based on surveillance data of healthcare-associated infection (HAI) after legal induced surgical abortion in women’s from January 2017 to 2019 in Ukraine. Definitions of HAI after induced abortion were used from the CDC/ NHSN. Results: The number of surgical abortions in Ukraine increased by 32.8%. A total of 25.9% HAIs were identified after surgical abortion. Of these HAIs, 25.9 were Endometritis, 21.8% Bacterial Vaginitis, 14.3% Parametritis, 13.1% Cervicitis, 9.9% Adnexa utery, 7.8% Salpingitis, 6.3% Chorioamnionitis, and 0.9% other reproductive tract infections. E.coli were most commonly reported, accounting for 25.9% of all organisms, followed by Enterococcus spp. (16.2%), Staphylococcus aureus (15.5%), P. aeruginosa (10.9%), and Enterobacter spp. (10.1%). Antimicrobial resistance in the isolates associated with HAIs showed, among the gram-positive bacteria, that 19.1% and 3.6% of coagulase-negative staphylococci isolates were b-lactam (oxacillin) − and glycopeptide-resistant, respectively. Meticillin resistance was reported in 23.2% of S aureus isolates. Vancomycin resistance was reported in 3.7% of isolated enterococci. Among the gram-negative bacteria, third-generation cephalosporins resistance was found in 33.1% of Klebsiella spp and in 24.1% of E.coli isolates. Conclusions: The results of this study revealed high rates of HAIs after surgical abortion and most causing pathogens were associated with resistant to antibiotic strains. This knowledge is essential to develop targeted strategies to surveillance and reduce the incidence of post-abortion infections.