Microbial Isolates and Antimicrobial Susceptibility Patterns among Women with Premature Rupture of Membranes at a Tertiary Hospital in Northwestern Nigeria

Premature rupture of membranes (PROM) is a major obstetric complication associated with maternal and neonatal infections. Knowledge of local microbial profiles and antimicrobial susceptibility patterns is essential for appropriate empirical antibiotic therapy. This study determined the genital microbial isolates and antimicrobial susceptibility patterns among women with PROM at the Federal Medical Centre, Gusau, northwestern Nigeria. A hospital-based matched case–control study was conducted among 162 pregnant women comprising 81 women with PROM and 81 matched controls with intact membranes. High vaginal and endocervical swabs were collected before antibiotic administration for culture, organism identification, and antimicrobial susceptibility testing using the Kirby–Bauer disc diffusion method following Clinical and Laboratory Standards Institute guidelines. Data were analysed using IBM SPSS version 22.0, with statistical significance set at p < .05. Women with PROM had significantly different microbial profiles from controls (p = .001). Escherichia coli was the predominant isolate in both endocervical (29.6%) and high vaginal (34.6%) swabs among cases, whereas Candida albicans predominated among controls. Approximately half of specimens yielded no microbial growth. Amoxicillin–clavulanate demonstrated the highest antimicrobial activity against most isolates, while susceptibility to ceftriaxone, cefuroxime, ciprofloxacin, gentamicin, and erythromycin was generally low, indicating substantial antimicrobial resistance. Escherichia coli was the predominant genital pathogen among women with PROM. The observed antimicrobial resistance highlights the need for routine culture, antimicrobial susceptibility testing, and periodic surveillance to guide empirical antibiotic therapy and strengthen antimicrobial stewardship.