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Empiric antibiotics for peripartum bacteremia: A chart review from a quaternary Canadian centre.

Authors :
Mohn, Sarah F.
Reimer, Renee
Mar, Nicole
Katelieva, Angela
Paquette, Vanessa
Albert, Arianne Y. K.
Roberts, Ashley
Tilley, Peter
McClymont, Elisabeth
Ting, Joseph
Boucoiran, Isabelle
Elwood, Chelsea
Source :
International Journal of Gynecology & Obstetrics. Feb2024, Vol. 164 Issue 2, p786-792. 7p.
Publication Year :
2024

Abstract

Objective: To evaluate the effectiveness of empiric antibiotic protocols for peripartum bacteremia at a quaternary institution by describing incidence, microbial epidemiology, clinical source of infection, susceptibility patterns, and maternal and neonatal outcomes. Methods: Retrospective chart review of peripartum patients with positive blood cultures between 2010 and 2018. Results: The incidence of peripartum bacteremia was 0.3%. The most cultured organisms were Escherichia coli (51, 26.7%), Streptococcus spp. (52, 27.2%), and anaerobic spp. (35, 18.3%). Of the E. coli cases, 54.9% (28), 19.6% (10), and 19.6% (10) were resistant to ampicillin, first‐ and third‐generation cephalosporins, respectively. Clinical sources of infection included intra‐amniotic infection/endometritis (115, 67.6%), upper and/or lower urinary tract infection (23, 13.5%), and soft tissue infection (8, 4.7%). Appropriate empiric antibiotics were prescribed in 137 (83.0%) cases. There were 7 ICU admissions (4.2%), 18 pregnancy losses (9.9%), 9 neonatal deaths (5.5%), and 6 cases of neonatal bacteremia (3.7%). Conclusion: Peripartum bacteremia remains uncommon but associated with maternal morbidity and neonatal morbidity and mortality. Current empiric antimicrobial protocols at our site remain appropriate, but continuous monitoring of antimicrobial resistance patterns is critical given the presence of pathogens resistant to first‐line antibiotics. Synopsis: Peripartum bacteremia was most associated with Escherichia coli, and while resistance to first‐line empiric antimicrobials is a concern, current antibiotic protocols remain appropriate. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
00207292
Volume :
164
Issue :
2
Database :
Academic Search Index
Journal :
International Journal of Gynecology & Obstetrics
Publication Type :
Academic Journal
Accession number :
174780644
Full Text :
https://doi.org/10.1002/ijgo.15048