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ORIGINAL RESEARCH article

Front. Microbiol.
Sec. Infectious Agents and Disease
Volume 15 - 2024 | doi: 10.3389/fmicb.2024.1454907
This article is part of the Research Topic Women in Infectious Agents and Disease: 2024 View all articles

Clinical characteristics associated with peripartum maternal bloodstream infection

Provisionally accepted
Xiaoli Gao Xiaoli Gao Yang Li Yang Li Sujuan Hou Sujuan Hou *Wenjun Fan Wenjun Fan Lingyi Fang Lingyi Fang Shijun Ni Shijun Ni *Ye Yan Ye Yan Jie Li Jie Li *Cha Han Cha Han *
  • Department of Obstetrics and Gynecology, Tianjin Medical University General Hospital, Tianjin, China

The final, formatted version of the article will be published soon.

    Introduction: Bloodstream infection (BSI) during the peripartum period is a major cause of maternal morbidity and mortality. However, data on maternal BSI during hospitalization for delivery are limited. This study aimed to investigate the incidence, clinical characteristics, risk factors, microbiological features, and antibiotic resistance patterns of maternal peripartum BSI, with a focus on understanding the role of premature rupture of membranes (PROM), fever, and other risk factors in its development. Methods: We investigated the clinical characteristics associated with maternal BSI during the peripartum period. This study included febrile women with blood cultures obtained during hospitalization for delivery. We analyzed the clinical characteristics, pathogenic microorganisms, antibiotic resistance, and maternal and neonatal outcomes of these patients. Participants were divided into BSI (n=85) and non-BSI (n=361) groups. Results: Spontaneous rupture of membranes, PROM, PROM >24 h before labor, vaginal examinations >5 times, and cesarean sections during labor were more common in the BSI group. Escherichia coli (51.8%; 44/85) was the predominant causative pathogen, followed by Enterococcus faecalis (7.1%, 6/85). Approximately 31.2% of E. coli were resistant to levofloxacin, and 38.6% were extended-spectrum β-lactamase-producing bacteria. The BSI group had higher rates of maternal sepsis and Apgar scores ≤7 at 1 min than the non-BSI group. Furthermore, PROM, fever ≥38.9 ℃ (102 °F), and fever within 24 h after delivery were risk factors for postpartum BSI in the adjusted analysis. Conclusion: Maternal BSI is a potentially life-threatening disease associated with PROM and the timing and severity of fever. Early identification and surveillance of pathogen composition and antimicrobial resistance can help prevent adverse outcomes.

    Keywords: delivery, peripartum, Bloodstream infection, Sepsis, Risk factors

    Received: 25 Jun 2024; Accepted: 28 Oct 2024.

    Copyright: © 2024 Gao, Li, Hou, Fan, Fang, Ni, Yan, Li and Han. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Sujuan Hou, Department of Obstetrics and Gynecology, Tianjin Medical University General Hospital, Tianjin, 300052, China
    Shijun Ni, Department of Obstetrics and Gynecology, Tianjin Medical University General Hospital, Tianjin, 300052, China
    Jie Li, Department of Obstetrics and Gynecology, Tianjin Medical University General Hospital, Tianjin, 300052, China
    Cha Han, Department of Obstetrics and Gynecology, Tianjin Medical University General Hospital, Tianjin, 300052, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.