Xiaoli Gao
Yang Li
Sujuan Hou
*
Wenjun Fan
Lingyi Fang
Ye Yan
The final, formatted version of the article will be published soon.
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- Department of Obstetrics and Gynecology, Tianjin Medical University General Hospital, Tianjin, China
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
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