Changing Trend of Neonatal Septicemia and Antibiotic Susceptibility Pattern of Isolates in Nepal

Phenotypic and genotypic characterization of methicillin resistant Staphylococcus aureus associated with pyogenic infections

Background and Objectives

Staphylococcal infections are one of the major infectious diseases affecting globally in spite of advances in development of antimicrobial agents. Knowledge and awareness about the local pattern and prevalence of MRSA infections plays a key role in treatment. The aim of this study was to identify MRSA strains by phenotypic and genotypic methods and to analyze the antibiotic susceptibility pattern of MRSA strains from patients attending a tertiary care hospital.

Materials and Methods

This study was conducted over a period of 1 year, where 296 isolates of Staphylococcus aureus were isolated from various clinical specimens. The isolated strains were examined for antibiotic susceptibility by the modified Kirby Bauer disc diffusion method. Methicillin resistance was detected by cefoxitin disk diffusion test.

Results

A total of 104 isolates were found to be MRSA and 192 were found to be MSSA. Among the 104 MRSA isolates, 10 strains that were multidrug resistant were subjected to 16S rRNA gene sequencing analysis. All the 10 strains had a 99% match with S. aureus strains that were responsible for causing some serious biofilm mediated clinical manifestations like cystic fibrosis and device mediated infections. The biofilms were quantified using crystal violet staining and their ability to produce biofilms was analyzed using scanning electron microscopy and matched with the Genbank.

Conclusion

Hence these phylogenetic analysis aid in treating the patients and combating resistance to antibiotics.

Coagulase-Negative Staphylococci in Neonatal Blood: How Concerning?

Objective Coagulase-negative staphylococci (CoNS) are being implicated as one of the leading causes of bloodstream infection (BSI). To study the spectrum, prevalence, and antimicrobial susceptibility of CoNS causing BSI in neonates.

Materials and Methods A cross-sectional study was done in level III neonatal intensive care unit (NICU). Blood samples in automated culture bottles were processed as per the standard technique. Previously validated methods were followed for the characterization of CoNS and for AST of standard antibiotics by Kirby Bauer disk diffusion and vancomycin by agar dilution. The prevalence of causative organisms and susceptibility of CoNS were statistically analyzed. Categorical variables were compared by chi-square or Fisher's exact probability tests.

Result In total, 1,365 blood samples (1,365 neonates) were studied, of which 383 (28.05%) were positive and 982 (71.94%) were negative. Gram-positive organisms (GPC) predominated (n = 238; 62.14%) (p < 0.001) with 41.77% (160/383) S. aureus and 13.83% (53/383) CoNS. CoNS included S. epidermidis (19, 38%), S. haemolyticus (7, 14%), S. hominis (6, 12%), S. simulans (6,12%), S. capitis (5,10%), S. cohnii (4, 8%), S. warneri (1, 2%), and S. xylosus (1, 2%). The susceptibility to netilmicin, linezolid, and vancomycin was 100% (p ≤ 0.001), and 54% (n = 27) had vancomycin MIC of 0.125 μg/mL but methicillin-resistant CoNS (MRCoNS) was 70%. Methicillin-susceptible (MS) CoNS had lower MIC of vancomycin (p < 0.05) than MRCoNS.

Conclusion The spectrum of pathogens causing BSI in neonates is changing with predominance of GPC and among CoNS, S. epidermidis. Considerable proportion of MRCoNS with the emergence of MIC creep for vancomycin requires immediate attention.

Bacterial etiology and risk factors among newborns suspected of sepsis at Hawassa, Ethiopia

Neonatal sepsis is a systemic infection that occurs at an early age. Its etiology varies from one region to the other. The contribution of sepsis to neonatal mortality and morbidity is significant in resource-limited countries; however, there is limited information about the etiology of sepsis in Sidama Regional State, Ethiopia. The aim of this study was to determine the prevalence of bacterial caused newborn sepsis, associated factors, and the antimicrobial susceptibility profile of bacteria. A hospital-based prospective cross-sectional study was conducted among 392 sepsis suspected newborns admitted to the neonatal intensive care unit of Hawassa University Comprehensive Specialized Hospital from March 2021 to November 2021. Blood specimens were collected and bacteria were isolated using the standard culture method. The drug resistance profile of bacteria was evaluated using the disk diffusion method. The socio-demographic and clinical parameters of participants were gathered using a questionnaire. Binary logistic regression was used to determine the determinants of sepsis. A variable with a p < 0.05 was considered a significant determinant of neonatal sepsis with a 95% confidence level. The prevalence of sepsis caused by bacteria among newborns was 143 (36.5%); 95% CI (31.3-41.4). The predominant bacteria was Klebsiella species (n = 61; 42.65%), followed by non-lactose fermenting Gram-negative bacteria (n = 27; 18.88%) and Enterococcus species (n = 26; 18.18%). The overall proportions of antimicrobial resistance of Gram-negative bacteria range from 10.2 to 99.1%. All Klebsiella species were resistant to ceftriaxone. Ppremature rupture of membrane [AOR = 12.7 (95% CI 6.430-25.106)], absence of respiratory support [AOR = 3.53 (95% CI 1.840-6.759)], sex of newborns [AOR = 2.10 (1.214-3.560)] and reason for admission [AOR = 3.17 (95% CI 1.278-7.859)] were significantly associated with culture-confirmed neonatal sepsis. This study indicated the contribution of bacteria in causing sepsis among newborns; the majority of them were Gram-negative bacteria. Most recovered bacteria were resistant to commonly used antibiotics. Pre-term, mode of delivery and types of respiratory support were significantly associated with the occurrence of sepsis caused by bacteria.

Length of Hospital Stay and Its Predictors Among Neonatal Sepsis Patients: A Retrospective Follow-Up Study

INTRODUCTION

Sepsis is common among neonates, and is often fatal. Hospitalization results in severe nosocomial infections which could be resistant to antibiotics. It also incurs higher fees for medical care.

METHODS

A retrospective follow-up study, which includes 206 neonates, was conducted to assess the length of hospital stay among neonatal sepsis patients from September 2018 to September 2020 at TASH Hospital, Addis Ababa, Ethiopia. Data were collected from medical charts. Mean length of hospital stay was compared using independent sample t-tests. Risk factors for length of stay were identified using binary logistic regression analysis.

RESULTS

All neonates stayed a total of 325 days, which gives 75,512 neonate-days. Neonates who stayed more than 7 days had low mean birth weight and higher mean age at admission. Mean length of stay was higher among neonates with comorbid illness, neonates with drug therapy problems and male neonates. Even though the mean length of stay is shorter among neonates with maternal PROM and CS delivery, these maternal factors were found to be insignificant in the multivariate logistic regression.

DISCUSSION

Similar to other studies, neonates with low birth weight and comorbidity had a longer hospital stay. Neonates with maternal PROM and CS delivery had a shorter stay. But these maternal factors, identified by prior studies as risk factors for neonatal sepsis and its mortality, are not found to be predictors of prolonged hospitalization. Having neurologic features and drug therapy problems among neonates with sepsis prolonged hospital stay.

CONCLUSION

The mean length of stay varies with respect to maternal and neonatal factors. Lower birth weight, presence of neurologic features, presence of comorbidity, presence of drug therapy problems and being male are found to be predictors of a longer hospital stay among neonates with sepsis.

Bacteriological Profile and Antibiotic Susceptibility Pattern of Neonatal Septicemia and Associated Factors of ICU Hospitalization Days

Purpose

To evaluate the microorganisms involved in neonatal septicemia and its antibiotic susceptibility pattern and to further investigate the factors associated with the length of intensive care unit (ICU) stay in neonatal septicemia.

Patients and Methods

A total of 297 infants with septicemia at neonatal ICU (NICU), Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology from 2016 to 2020 were enrolled. Identification of bacterial species was done using the standard positive blood culture. Data included demographics, signs at time of septicemia, laboratory values, patient sources, complications, microbiologic characteristics, and the duration of ICU stay. Univariate and multivariate gamma regression analyses were applied to determine the variables associated with ICU stay.

Results

The result demonstrated that the main causative pathogens of neonatal septicemia in our hospital were Gram-positive bacteria, among which Staphylococcus epidermidis (100 isolates, 47.17%) was the main conditional pathogens; Escherichia coli (27 isolates, 49.09%) was most frequently isolated among Gram-negative pathogens. Gram-positive bacteria had higher susceptibility to vancomycin, tigecycline and linezolid. Escherichia coli was susceptive to piperacillin (27/27, 100.00%), cefotetan (27/27, 100.00%), meropenem and imipenem (27/27, 100.00%). Streptococcus agalactiae (95% CI: 0.140–0.539), for patients who were transferred from other hospital (95% CI: 0.016 to 0.354), septicemia during hospitalization (95% CI: 0.411 to 0.825), the use of antibacterial drug during pregnancy (95% CI: 0.362 to 2.136), feeding intolerance (95% CI: 0.127 to 0.437), bradycardia (95% CI: 0.196 to 0.838), septicemia newborns have complications (95% CI: 0.063 to 0.291), the onset age (95% CI: 0.006 to 0.023), TRIPS score (95% CI: 0.005 to 0.016), and CRP level (95% CI: 0.002 to 0.005) were related to prolonged ICU stay days.

Conclusion

This study summarized common pathogens and associated drug sensitivity, and factors influencing ICU stay length. Prevention and control policy in the NICU should be strengthened.

Common Bacterial Isolates Associated With Neonatal Sepsis and Their Antimicrobial Profile: A Retrospective Study at King Abdulaziz University Hospital, Jeddah, Saudi Arabia

Background

Neonatal sepsis is a major contributor to morbidity and mortality among neonates. There has been considerable geographic variation in causative pathogens and antimicrobial sensitivity profiles over time. This makes the continuous monitoring of patterns of emergence crucial for the effective implementation of antimicrobial therapy guidelines in an attempt to control antimicrobial resistance.

Methods

A retrospective study was conducted among neonates with sepsis admitted to King Abdulaziz University Hospital, Jeddah, Saudi Arabia, between May 2011 and October 2018. The data were collected from medical records in the neonatal intensive care unit and analyzed using SPSS version 20 (IBM Corp., Armonk, NY).

Results

There were 246 neonates clinically diagnosed with sepsis, of whom 40 (16.26%) had positive blood cultures. In the blood cultures, coagulase-negative Staphylococcus was the most prevalent microorganism (57.5%), followed by Klebsiella spp. (10%). Streptococcus agalactiae, Enterobacter cloacae, Escherichia coli, Acinetobacter baumanii, and Candida spp. each accounted for 5% of all isolates. Only single isolates of methicillin-resistant Staphylococcus aureus, Pseudomonas aeruginosa, and Bacillus spp. (2.5% each) were detected in this study. Most of the isolated microorganisms exhibited high sensitivity to ampicillin and gentamicin.

Conclusions

This study points to a likely emergence of coagulase-negative Staphylococci as the main cause of sepsis among neonates. Ampicillin and gentamicin are highly effective against the commonly isolated bacterial pathogens that cause neonatal sepsis.

Bacteriological profile, antibiotic susceptibility and factors associated with neonatal Septicaemia at Kilembe mines hospital, Kasese District Western Uganda

Introduction

Neonatal septicaemia is one of the most common leading causes of neonatal morbidity and mortality in developing countries. It is estimated to affect more than 30 million people worldwide annually, potentially leading to 6 million deaths.

Objective(s)

To determine the prevalence, bacteriological profile, antibiotic susceptibility and factors associated with neonatal septicaemia among neonates suspected to sepsis at Kilembe mines hospital.

Methods

We conducted a descriptive cross-sectional study, where purposive sampling technique was used and blood was drawn from 122 neonates suspected to sepsis attending Kilembe Mines Hospital during the period (July to November 2020). Specimens were inoculated in Brain heart infusion broth, transported to Fortportal Regional Referral Hospital, plated daily up to 7 days on blood, chocolate, MacConkey agar and incubated in aerobic and 5% carbondioxide. Pure colonies were identified by Gram stain, biochemical tests and antibiotic sensitivities obtained by Kirby Bauer disc diffusion method. Associations were tested using Chi square with Fisher’s exact or Yates correction tests where necessary and statistical significance was set at P < 0.05. Stata (version 14) used for statistical analysis.

Results

Blood cultures were positive in 59.0% cases with 55.5% male and 44.4% female. EOS was present in 56.9% and LOS 43.1% of the cases. Gram negative (56.9%) organisms were most implicated with neonatal septicaemia than Gram positives ones (43.1%). Gram positive organisms exhibited better susceptibility to amikacin, linezolid and vancomycin but more resistant to ampicillin and gentamicin. Of the aminoglycosides, amikacin exhibited a verge over netilmicin and gentamicin against Gram negative isolates. Risk factors of neonatal septicaemia were mother’s age of ≥25 years, employed mothers, tertiary-level of education, SVD, ANC attendance of ≥4 times, UTI during pregnancy, PROMS, foul Smelling liquor, urban residence, neonatal birth weight of ≥2500 g, Apgar score 1st and 5th min ≥6 and resuscitation.

Conclusion

Multi-drug resistant organisms were isolated. Therefore caution is required in selection of antibiotic therapy and avoid empirical treatment.

Trend Analysis of Multidrug-Resistant Bacterial Pathogens Causing Neonatal Sepsis at University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia: A Retrospective Study

Background

Neonatal sepsis is the most common cause of mortality and morbidity. It is a major global public health challenge, particularly in developing countries. Therefore, knowing the current status of bacterial isolates and their antimicrobial resistance profile is essential to physicians and health workers to implement appropriate intervention. The aims of this study was to assess a ten-year trend of bacterial prevalence isolates from blood culture among neonates (<1 month of age).

Method

A hospital-based retrospective study was conducted on 1854 neonatal patients who were admitted at University of Gondar Specialized Comprehensive Hospital between 2010 and 2020. Sociodemographical and laboratory data were collected from medical records. Quality of the data was assured through standard operational procedures. Data were entered and analysed using SPSS version 20. Bivariate analysis was employed to determine strings of association between the outcome variable and sociodemographic variables. A P value less than 0.05 will be considered to be statically significant.

Results

In a total of 1854 patients, 538 (29%) were culture positive. The overall neonatal sepsis infection rate was 287 (53.5%) for male and 249 (46.5%) for female. The highest proportion of neonatal sepsis infection rate was observed among the patients in the age range between 3 and 28 days and gestational at birth <37 weeks, 461(86%) and 278 (52%), respectively. Gestational at birth (P ≤ 0.001, AOR = 5.81, CI: 4.63–7.29) is significantly associated with bacterial isolates. The predominant pathogens were Staphylococcus aureus, 18 (76.6%), Klebsiella pneumoniae, 146 (38%), and E. coli, 45 (11.7%) among the age range less than one weak. Klebsiella spp, S. aureus, and E. coli showed a high level of resistance to most tested antimicrobials. Amikacin, ciprofloxacin and norfloxacin, and erythromycin were the most effective antibiotics whereas ampicillin, amoxicillin, and cotrimoxazole were the least effective antibiotics for isolates.

Conclusion

Neonatal sepsis infection is common in the 3–28 days of age range. S. aureus, E. coli, and K. pneumonia were the most common isolates. Most the bacterial pathogens were resistant to commonly prescribed antibiotics. Therefore, an antimicrobial sensitivity test for bacterial isolates is recommended to provide updated data for the physician in choosing the appropriate antibiotic for better patient treatment outcome.

Epidemiology and Pathogenesis of Staphylococcus Bloodstream Infections in Humans: a Review

Staphylococci are among the most frequent human microbiota components associated with the high level of bloodstream infection (BSI) episodes. In predisposed patients, there is a high risk of transformation of BSI episodes to sepsis. Both bacterial and host factors are crucial for the outcomes of BSI and sepsis. The highest rates of BSI episodes were reported in Africa, where these infections were up to twice as high as the European rates. However, there remains a great need to analyze African data for comprehensive quantification of staphylococcal BSI prevalence. The lowest rates of BSI exist in Australia. Asian, European, and North American data showed similar frequency values. Worldwide analysis indicated that both Staphylococcus aureus and coagulase-negative staphylococci (CoNS) are the most frequent BSI agents. In the second group, the most prevalent species was Staphylococcus epidermidis, although CoNS were not identified at the species level in many studies. The lack of a significant worldwide decrease in BSI episodes indicates a great need to implement standardized diagnostic methods and research etiological factors using advanced genetic methods.

Predominance of Gram-negative infections a cause of neonatal sepsis among low birth weight preterm infants

Objectives

Neonatal sepsis continues to be a leading and most important cause of mortality among low birth weight (LBW) preterm infants.

Methods

The study group included 226 LBW preterm infants with sepsis. A total of 100 normal birth weight infants with sepsis served as control. Blood and cerebrospinal fluid (CSF) samples collected for microbiological culture and processed according to standard protocol. Antibiotic resistance patterns were performed following standard guidelines.

Results

Out of 226 LBW preterm infants 106 (46.9%) showed positive blood culture, of which 52 (49%) Escherichia coli, 28 (26.4%) Klebsiella pneumoniae, 12 (11.32%) Enterobacter spp., 4 (3.7%) Pseudomonas aeruginosa, 2 (1.88%) Acinetobacter spp., 5 (4.7%) methicillin-resistant Staphylococcus aureus (MRSA), 3 (2.8%) Staphylococcus epidermidis were isolated. Out of 100 control group infants, 46 (46%) showed positive blood cultures, of which 18 (39.1%) E. coli, 12 (26.08%) Enterobacter spp., 8 (17.39%) K. pneumoniae, 1 (2.17%) P. aeruginosa, 2 (4.34%) MRSA, 3 (6.52%) S. epidermidis and 2 (4.34%) Candida spp. were isolated. Cephalosporin and Penicillin group showed highest resistance with 58 and 52%, respectively. Aminoglycosides showed 22% resistance. The control group showed highest resistance of 62% to the Penicillin group, 54% cephalosporin and 18% for aminoglycosides.

Conclusions

Our study highlights on the surveillance of resistant pathogens causing sepsis in LBW preterm infants emphasizing antimicrobial stewardship to control the mortality rate.

Treatment outcomes, antibiotic use and its resistance pattern among neonatal sepsis patients attending Bahawal Victoria Hospital, Pakistan

BACKGROUND

Sepsis is one of the major causes of neonatal mortality in Pakistan. This study aimed to investigate the treatment outcomes, antibiotic use and its resistance pattern among neonatal sepsis patients attending a tertiary care hospital in Pakistan. We also aimed to identify the factors affecting mortality in neonatal sepsis patients.

METHODS

A descriptive, cross-sectional study was conducted in the pediatric wards of the Bahawal Victoria Hospital, Bahawalpur, Pakistan. All eligible neonatal sepsis patients who were registered at the study site from January 1, 2019 to June 30, 2019 were included in the study. The data collection form included information on patient's characteristics, antibiotic use and its sensitivity pattern, laboratory and microbiological data, and final treatment outcomes. Treatment outcomes included, discharged (with treatment success), leave against medical advice (LAMA), discharged on request (DOR) and death. Multivariable binary logistic regression analysis was used to find the independent factors associated with death. A p-value of less than 0.05 was considered statistically significant.

RESULTS

Among the total 586 patients, 398 (67.9%) were male, 328 (56%) were preterm, 415 (70.8%) were diagnosed with early onset sepsis, 299 (51%) were born with low birth weight. Most of the patients (n = 484, 82.6%) were treated with amikacin+cefotaxime at the start of treatment. Culture was positive in 52 (8.9%) patients and the most commonly identified bacteria included, Klebsiella species (n = 19, 36.5%) followed by E. coli (n = 15, 28.5%) and Staphylococcus aureus (n = 8, 15.4%). The identified bacterial isolates showed high level of resistance against the antibiotics initiated at the start of the treatment, while resistance against piperacillin+tazobactam, imipenem, vancomycin and linezolid was very low. Just under half of the patients (n = 280, 47.8%) successfully completed the treatment (i.e., discharged with treatment success), while 123 (21%) patients died during treatment. In multivariable binary logistic regression, the factors which still remained significantly associated with neonatal death included, preterm delivery (AOR 9.59; 95% CI 4.41, 20.84), sub-optimal birth weight (AOR 5.13; 95% CI 2.19, 12.04), early onset sepsis (AOR 2.99; 95% CI 1.39, 6.41) and length of hospital stay (AOR 0.76; 95% CI 0.67, 0.88).

CONCLUSION

The mortality rate associated with sepsis was high in our study cohort. The bacterial isolates showed high level of resistance against the antibiotics started as the empiric therapy. Rational use of antibiotics can decrease the adverse outcomes in neonatal sepsis patients.

Study of Antibiotic Susceptibility among Bacterial Isolates in Neonatal Intensive Care Unit of a Tertiary Care Hospital: A Descriptive Cross-sectional Study

Introduction:

Neonatal sepsis is a major cause of neonatal morbidity and mortality worldwide, especially in developing countries like Nepal. Antibiotic resistance among microorganisms poses new challenges in the treatment of neonatal sepsis. The present study is conducted with the objectives of determining clinico-bacteriological profile and antibiotic susceptibility among isolated bacteria in a neonatal intensive care unit.

Methods:

A descriptive cross-sectional study was conducted from January 1, 2017, to December 31, 2019, in the neonatal intensive care unit of a tertiary care hospital after obtaining ethical clearance from Institutional Review Committee (Ref: 2020-064). The sample size was calculated and 77 neonates with culture-proven sepsis were included in the study. The antibiotic susceptibility tests of the isolates were done by Kirby-Bauer disc diffusion method. Data entry was done in Statistical Packages for the Social Sciences version 20.

Results:

Of the 841 specimens (blood, cerebrospinal fluid, urine, tracheal aspirate and pus) processed for culture, bacteria were isolated in 84 (10.0%) specimens. Among the 84, gram-negative bacilli were the predominant isolates 76 (90.5%); of which Acinetobacter baumannii was the most common 27 (32.1%). Both the Gram-negative and the Gram-positive bacteria showed high resistance to Penicillin and Cephalosporins. Gram-negative bacteria showed maximum sensitivity to Colistin, Carbapenems, Tigecycline and Fluoroquinolones. Gram-positive bacteria showed maximum susceptibility to Amikacin, Vancomycin and Carbapenems.

Conclusions:

Judicious use of antibiotics based on the updated knowledge of prevalent organisms in the local hospital setting and their antibiotic sensitivity pattern is of utmost importance for the effective treatment of neonatal sepsis.

A Cross-sectional Study of Group B Streptococcus-Associated Sepsis, Coinfections, and Antibiotic Susceptibility Profile in Neonates in Pakistan

BACKGROUND

Neonatal sepsis is a leading cause of morbidity and early-life mortality worldwide, and previous data have reported the highest neonatal mortality rate in Pakistan.

PURPOSE

The present study aimed to decipher the prevalence of group B Streptococcus (GBS)-associated sepsis, coinfections, and antibiotic susceptibility of isolated microbes in neonates.

METHODS

Blood samples of 100 cases of neonatal sepsis were subcultured on blood agar, GBS agar, and MacConkey agar for isolation of GBS and suspected microbes.

RESULTS

Of 100 neonatal blood samples, 85 blood samples were culture-positive, including mixed culture growth (n = 18), 25 samples as early-onset neonatal sepsis (EONS) and 60 as late-onset neonatal sepsis (LONS). Staphylococcus aureus showed high percent positivity (31.4%), followed by Candida sp (16.5%), GBS (14.1%), Klebsiella (14.1%), Staphylococcus epidermidis (11.8%), Pseudomonas (9.4%), Acinetobacter (9.4%), Esherichia coli (8.2%), and Enterococcus (5.9%). GBS was isolated more frequently from EONS than from LONS with 50% coinfections. Mode of delivery, gender, and respiratory distress in neonates were significantly associated with culture-positive sepsis. GBS isolates were highly (91.7%) susceptible to vancomycin, cefotaxime, and chloramphenicol, followed by penicillin (83.3%), ampicillin, and tetracycline (75%). GBS isolates were resistant to erythromycin, clindamycin, ciprofloxacin, and linezolid.

IMPLICATIONS FOR PRACTICE

Our findings evidenced GBS-associated risk factors and antibiotic susceptibility pattern of neonatal sepsis, which will help clinicians in management, control, and treatment of neonatal sepsis.

IMPLICATIONS FOR RESEARCH

The epidemiological evidence of GBS-associated neonatal sepsis, demographic characteristics, risk factor data analysis, and drug resistance pattern has disease prevention implications in neonates in low-income countries including Pakistan.

[The structure of conditionally pathogenic microflora, isolated from the urogenital tract of women with pathological course of pregnancy.]

The structure of the microflora of the urogenital tract of a woman is variable and diverse, changing its qualitative and quantitative composition can affect various physiological processes in the body of a woman, including the course of pregnancy. In this study, the results of cultures of 1415 samples of urine and cervical canal discharge of pregnant women were analyzed. Species identification was carried out by MALDI-ToF mass spectrometry using Microflex LT (Bruker) mass spectrometer. Gram-positive bacteria (69.5%) dominated the structure of the cervical canal microflora, among which Staphylococcus spp prevailed., Enterococcus spp. and Lactobacillus spp. Among gram-negative bacteria most often encountered microorganisms of the order Enterobacteriales, the predominant species among which was E. coli. Also, yeast-like fungi were isolated from the material of the cervical canal, their number was 11% of the total number of crops. Qualitative microbiological composition of urine was represented by gram-positive flora (68.7%), gram-negative flora (30.1%) and Candida fungi (1.2%). There is a significant predominance of coagulase-negative staphylococci (97.3%) over coagulase-positive (2.7%) in the structure of gram-positive microorganisms. The composition of gram-negative flora is mainly represented by bacteria of the order Enterobacteriales (71.4%). The study identified microorganisms that can cause postpartum complications and the development of inflammatory diseases of the newborn, which suggests the need for regular microbiological examination for pregnant women.