Epidemiological Profile of Microorganisms Associated with Female Infertility at the Mother and Child University Hospital Center of N’Djamena: Risk Factors and Antibiotic Resistance

Abstract

Aims: the objective of this work was to determine the resistance phenotypes and the epidemiological profile of microorganisms associated with female infertility at the CHU-ME of N’Djamena. Materials and Methods: we conducted a prospective, cross-sectional and analytical study on women admitted for maternity desire at the CHU-ME of N'Djamena and consenting from June 1, 2022 to February 26, 2023. Isolation and identification microorganisms responsible for female infertility were carried out in the laboratories using standard clinical microbiology methods. Results: Of the 122 patients included in this series due to infertility, 88 (72.13%) tested positive for microbial infection compared to 34 (28%) negative tests (p = 0.01). The average age of infertile women was 34.24 years with extremes ranging from 19 to 45 years. The age groups most affected were 25 to 31 and 32 to 38. Primary infertility was 71.31% and secondary 28.68%. The microorganisms most associated with infertility were Chlamydia trachomatis (25.30%), Mycoplasma hominis (17.90%), Candida albicans (16.66%) and Staphylococcus aureus (16.04%) Streptococcus agalactiae (10 .49%) and Ureaplasma spp (8.14%). The risk factors most associated with infertility were advanced age (18.85%), surgical interventions (17.25%) and ovulation disorders (19.39%). The antecedents most associated with infertility were cesarean section 44 (36.07%) followed by miscarriages 29 (23.77). The sensitivity of bacterial and fungal agents to antibiotics and antifungals was varied. The majority of bacteria were resistant to Cyclins, Betalactams and Macrolides with proportions of 66%, 47.66% and 34% respectively. Strains of Ureaplasma spp and Mycoplasma homonis develop average resistances of 86.52% and 36.16% respectively against fluoroquinolones. The fungal strains were sensitive (54.33%) to the azole derivatives and resistant (70%) to the polyenes tested. Conclusion: The present study made it possible to determine high prevalence of microorganisms and risk factors associated with female infertility. It also highlighted high prevalence of resistance of bacteria to beta-lactams and fluoroquinolones and of Candida albicans to polyenes.