Antibiotic Susceptibility Profiles and Determinants of Septic Abortion Among Women Admitted for Abortion Care in Ugandan Satellite Teaching Hospitals: A Two‐Center Cross‐Sectional Study

Background and Aims: Septic abortion remains a major cause of maternal morbidity and mortality in low- and middle-income countries. This study aimed to determine the prevalence, antibiotic susceptibility profiles, and determinants of septic abortion among women admitted for abortion care in Ugandan satellite teaching hospitals. Methods: This two-center cross-sectional study was conducted at Fort Portal and Hoima Regional Referral Hospitals between May and September 2023. Consecutive women admitted for abortion care were enrolled. Participants were initially identified based on clinical signs and symptoms suggestive of septic abortion, including fever ( ≥ 38°C) and features of genital tract infection. Microbiological diagnosis was subsequently confirmed using culture and antibiotic susceptibility testing. Endocervical swabs from clinically suspected cases were cultured, and antimicrobial susceptibility testing was performed using the Kirby-Bauer disk diffusion method and interpreted according to Clinical and Laboratory Standards Institute (CLSI) guidelines. Logistic regression was used to identify factors associated with septic abortion. Results: . High resistance was observed to commonly used antibiotics, whereas higher susceptibility was noted for reserve antibiotics. Rural residence and lack of contraceptive use were independently associated with septic abortion (adjusted odds ratios reported with 95% confidence intervals). Conclusions and Recommendations: Septic abortion remains common among women admitted for abortion care in these Ugandan hospitals and is characterized by substantial antimicrobial resistance to commonly used agents. Strengthening access to effective contraception, promoting early care-seeking, and guiding empiric treatment using local antimicrobial susceptibility patterns are essential to reduce morbidity.