Vaginal culture examinations
Since 2010, our institution has introduced a practice protocol in which
upper vaginal culture is routinely performed for high-risk patients
diagnosed with pPROM, PTL, IIOC, and short CL. Vaginal culture samples
were collected under sterile technique using a sterile swab and a
sterile non-lubricated speculum and transported to the laboratory for
analysis using a suitable transportation medium. The samples were
Gram-stained and cultured according to the standard laboratory
procedures of our institution. They were directly inoculated on a blood
agar plate, MacConkey agar plate, and Thayer–Martin agar plate and
incubated at 35°C for up to 72 h in a 5% CO2 incubator.
Antimicrobial susceptibility testing, including that for ESBL-E
activity, was performed using the VITEK 2 system (bioMérieux, Hazelwood,
MO). Cefepime, cefotaxime, ceftazidime, cefepime/clavulanic acid,
cefotaxime/clavulanic acid, and ceftazidime/clavulanic acid were
included in the ESBL-E testing using the VITEK 2 system. There was no
significant change in the diagnostic method for ESBL-E during the study
period.