Vaginosis and Antimicrobial Susceptibility Patterns of Bacterial Isolates from High Vaginal Swabs among Women in Sabratha, Western Libya

Abstract

Bacterial colonization of the female genital tract is a major contributor to maternal morbidity, and the emergence of multidrug-resistant organisms complicates treatment. Local microbiological surveillance is therefore essential to guide appropriate therapy and reduce infection-related complications. This study aimed to determine the prevalence of bacterial pathogens in high vaginal swabs (HVS), assess their antimicrobial susceptibility patterns, and identify factors associated with bacterial colonization among women in Sabratha, Western Libya. A cross-sectional observational study was conducted on fifty women who provided high vaginal swabs. Samples were collected aseptically using deep swabs, cultured on selective media, and bacterial isolates were identified using standard microbiological techniques, including Gram staining and biochemical tests. Antimicrobial susceptibility testing was performed according to Clinical and Laboratory Standards Institute (CLSI) guidelines. Among the fifty HVS samples, a total of sixty bacterial isolates were recovered. Streptococcus species were the most frequently identified, accounting for thirty isolates, representing 50% of all bacterial isolates. Escherichia coli and Staphylococcus aureus were each identified in fifteen isolates, representing 25% of the total isolates for each species. Multidrug resistance was observed across all three bacterial groups. Carbapenems, including meropenem and imipenem, as well as gentamicin, demonstrated the highest levels of susceptibility, whereas macrolides, such as azithromycin, and tetracycline showed considerable resistance. The findings indicate that polymicrobial colonization is common in vaginal samples, and highlight the predominance of Streptococcus species in this population. Streptococcus species are the predominant vaginal isolates among women in Sabratha, followed by E. coli and S. aureus. Carbapenems remain highly effective against these isolates; however, resistance to macrolides and tetracycline underscores the importance of culture-guided antimicrobial therapy. Continuous local surveillance and evidence-based treatment strategies are essential to manage multidrug-resistant vaginal pathogens effectively.