Malaysian Journal of Microbiology, Vol 15(7) 2019, pp. xxx-xxx DOI: http://dx.doi.org/10.21161/mjm.190402 Malaysian Journal of Microbiology Published by Malaysian Society for Microbiology (In since 2011) 1 ISSN (print): 1823-8262, ISSN (online): 2231-7538 *Corresponding author Colonization of Acinetobacter baumannii, Streptococcus agalactiae (GBS) and Candida albicans in preterm premature rupture of membrane (PPROM) compared to normal labor at term Zaini Mohd-Zain 1 , Ofelia Yahcob 1 , Mini Sood 2 , Nor Azizah Abu 1 , Mohd Roslan Abdul Halim 3 , Noor Shafina Mohd Nor 1, 4* 1 Faculty of Medicine, Sungai Buloh Campus, Universiti Teknologi MARA, 47000 Sungai Buloh, Selangor, Malaysia 2 Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, 47500 Bandar Sunway, Selangor, Malaysia 3 Selayang Hospital, 68100 Batu Caves, Selangor, Malaysia 4 Institute for Pathology, Laboratory and Forensic Medicine (I-PPerForM), Universiti Teknologi MARA (UiTM), Sungai Buloh, Selangor, Malaysia Email: shafinamohdnor@yahoo.com; drshafina@salam.uitm.edu.my Received 18 March 2019; Received in revised form 10 May 2019; Accepted 8 July 2019 ABSTRACT Aims: Preterm premature rupture of membrane (PPROM) is usually associated with maternal vaginal colonization of Group B Streptococci (GBS). However, there are reports on isolation of Acinetobacter baumannii in PPROM cases. In order to ascertain A. baumannii’s role in PPROM, we determine the colonizati on of A. baumannii and other common vaginal tract flora, i.e. GBS and Candida albicans, in women with PPROM, and compared them to those with normal labor at term (NLT). The transmissibility of the organisms to their babies was also investigated. Methodology and results: A total of 218 high vaginal swabs from 108 and 100 women with PPROM and NLT respectively were collected. The transmission of these organisms to their 215 babies was determined by swabbing the ears and axillae. These were cultured for isolation of A. baumannii, GBS and C. albicans. Results showed that mothers with PPROM were predominantly colonized with GBS (32.4%), followed by C. albicans (19.4%) and A. baumannii (7.4%), compared to 10.9%, 17.3% and 7.2% respectively, in women with NLT. Between 34 to 50% of the babies of mothers with PPROM acquired the organisms, with GBS being the most significantly (p=0.000) transferred compared to other organisms. Co-existence of A. baumannii with either GBS or C. albicans, or both, did not enhance the occurrence of PPROM. Conclusion, significance and impact of study: Colonization of A. baumannii in vaginal tract of pregnant women does not increase the possibility of PPROM, as compared to GBS. Keywords: Acinetobacter baumannii, Streptococcuc agalactiae, Candida albicans, Preterm premature rupture of membrane (PPROM), Term labor INTRODUCTION Premature rupture of membrane (PPROM) is the rupture of membrane prior to the onset of labor in pregnancy less than 37 weeks of gestation. It is an obstetric complication that can lead to sepsis in neonates since pathogens are frequently acquired during vaginal delivery. Newborns of mothers with risk factors for infections, such as PPROM are 2.3 times more likely to acquire infection compared to those without risk factors (Chan et al., 2013). Colonization of Streptococcus agalactiae (Group B Streptococcus, GBS) in the vaginal tract during pregnancy has been recognized to enhance PPROM (Schuchat, 1999). A systematic review, however, showed contradictory findings on the association of GBS with preterm delivery (Valkenburg et al., 2009). Furthermore, one report suggested that A. baumannii is associated with PPROM, spontaneous abortion and neonatal mortality, but the role of the organism in these cases was not discussed (He et al., 2013). A. baumannii is an aerobic, non-motile gram-negative bacillus bacterium that has emerged to be a prevalent cause of hospital-acquired infections (Peleg et al., 2008). This bacterium is ubiquitous and able to survive in various environment. It is also capable of adhering on abiotic surfaces as well as in moist devices such as ventilators