The following is a summary of “Peripartum bacteremia: bacterial epidemiology, antibiotics, and neonatal outcomes,” published in the FEBRUARY 2023 issue of Obstetrics and Gynecology by Mohn S et al.

For a study, researchers sought to describe the microbial epidemiology, use of empiric antibiotics, and clinical outcomes of peripartum patients with confirmed bacteremia to optimize infection protocols and improve morbidity and mortality outcomes associated with peripartum bacteremia.

The study design was a retrospective chart review of 104 peripartum patients with positive blood cultures and 111 respective neonatal charts in a tertiary care center between 2014-2018. 

104 incidences of bacteremia (0.37%) were reported among 27,867 births. Chorioamnionitis (61.5% of infections) was the most frequent cause. Streptococcus (31.4%), anaerobes (31.4%), and E. coli (19%) were the most prevalent infections, each accounting for 31.4% of cases. 60.9% of the E. coli cultures tested negative for ampicillin, 26.1% for first-generation cephalosporins, 26.1% for third-generation cephalosporins, and 4.3% for piperacillin/tazobactam. 25% of the methicillin-resistant Staphylococcus species that were cultivated. For 13 (12.5%) obstetric patients, transfer to a higher level of care was necessary. Of the 111 fetuses, there were 22 (19.8%) needed care in the neonatal critical care unit, six (5.4%) neonatal deaths, and five (4.5%) cases of fetal demise. Two of the four (3.6%) neonates with positive blood cultures had infections that matched those in their mother’s blood.

The study concluded that peripartum bacteremia was associated with maternal and neonatal morbidity and mortality. Significant E. coli resistance to ampicillin and cephalosporins, first-line therapies at the site. Compared to data from the previous four years, rates of E. coli resistance to ampicillin and cephalosporins have increased, indicating an ongoing need for surveillance to optimize infection protocols.

Reference: ajog.org/article/S0002-9378(22)01004-3/fulltext