Clinical charateristics and pathogen distribution of bloodstream infections in obstetric patients:a report of 111 cases / 中国感染与化疗杂志

ABSTRACT

Objective To investigate the clinical characteristics of bloodstream infections in obstetric patients and analyze the distribution and antimicrobial susceptibility of the pathogenic organisms. Methods The clinical data of bloodstream infections in obstetric patients treated in the Third Affiliated Hospital of Guangzhou Medical University from December 2014 to December 2017 were studied retrospectively. Results A total of 111 cases were identified, including 31(27.9％)during pregnancy and 80(72.1％)after delivery. Most(79.3％, 88/111)of these patients had obstetric disease or complication, and urinary, abdominal or intrauterine infection was found in 15(13.5％)cases. All patients had fever, and 7 cases showed septic shock. After treatment, 109(98.2％)patients were cured, despite infectious abortions in 6 cases. A total of 118 isolates were collected, including 31(26.3％)from pregnant women and 87(73.7％)isolates from puerperants. Gram-negative organisms, gram-positive organisms and Candia accounted for 58.5％, 39.0％, and 2.5％, respectively. The most common pathogens identified were Escherichia coli(44.1％), Enterococcus spp.(22.0％), and Staphylococcus spp.(5.1％). The prevalence of ESBLs-producing strains was 62.5％ in E. coli. All the E. coli strains were susceptible to piperacillin-tazobactam, imipenem, and tigecycline. No Enterococcus isolates were resistant to vancomycin or tigecycline. About 88.5％ of the Enterococcus strains were susceptible to ampicillin. Conclusions Bloodstream infection in obstetric patients usually occurs after delivery, probably resulting in septic shock or infectious abortion. The main pathogens are gram-negative bacteria and Enterococcus spp. The prevalence of ESBLs-producing strains was high in E. coli. Most of the Enterococcus strains were susceptible to ampicillin.