May 13, 2017
Puerperal sepsis causes 10% of maternal deaths in Africa, but prospective studies on incidence, microbiology, and antimicrobial resistance are lacking. This is a prospective cohort study of 4,231 Ugandan women presenting to a regional referral hospital for delivery or postpartum care. It was found that women in rural Uganda with postpartum fever have a high rate of antibiotic resistance among cultured urinary and bloodstream infections. Increasing availability of microbiology testing to inform appropriate antibiotic use, development of antimicrobial stewardship programs, and strengthening infection control practices should be high priorities.