Analysis of risk factors, pathogenic bacteria of maternal sepsis in term pregnant women with positive blood culture during hospitalization

Abstract

The objective of this study was to evaluate the risk factors, pathogenic bacteria and drug sensitivity of maternal sepsis, and provide evidence for clinical prevention and treatment. A retrospective investigation of pregnant women with full-term maternal sepsis was performed to analyze the risk factors, pathogenic bacteria, and drug sensitivity of maternal sepsis. Univariate analysis showed that temperature, serum procalcitonin (PCT) and C-reactive protein (CRP) at admission, white blood cell count (WBC), PCT, CRP and neutrophilic granulocyte percentage (N%) during fever, premature rupture of membranes (PROM), antibiotic use within 1 week, mode of production, onset and duration of fever, between groups were statistically significant (P < .05). Logistic regression analysis showed that cesarean section was an independent risk factor for sepsis (OR = 11.839, 95%CI: 3.121–44.906). Apparent increase was found in body temperature (OR = 3.664, 95%CI: 1.722–7.795), duration of fever (OR = 1.953, 95%CI: 1.242–3.071), and PCT (OR = 1.080, 95%CI: 1.002–1.163). Also, increasing neutrophil ratio (OR = 1.180, 95%CI: 1.073–1.297) indicated a high possibility of maternal sepsis. The organism Escherichia coli (E. coli) was the most common pathogenic bacteria in the positive blood culture group (90%), and the sensitivity to carbapenems (meropenem and imipenem/cilastatin) was 100%, that to piperacillin-tazobactam and amoxicillin sulbactam was over 90%, and that to ceftazidime was 95%. Cesarean section was an independent risk factor for maternal sepsis in term pregnant women with positive blood culture. Besides, the E. coli was the most common pathogenic bacteria in the positive blood culture group. Antibiotics should be used in time and reasonably when the temperature was significantly increased with elevated PCT and N% after a cesarean section.

The association between premature rupture of membranes (PROM) and preterm gestational age with neonatal sepsis: a systematic review and meta-analysis

“…Only two studies found the incidence of PROM to be smaller in the non-sepsis than the sepsis group.7,24 Eleven studies found a higher incidence of PROM in the sepsis than the non-sepsis group. 17,18,23,26,27,29,31,33,[37][38][39] In the remaining eight studies, the ORs were not statistically significant. [19][20][21][22]25,28,30,35 Since the data were heterogenous (I 2 =86%), a random effects model was used for analysis.…”

“…Wen et al 31 also noted that maternal history of PROM was more common in neonates with sepsis because the need for induced labor increases after PROM, leading to an increase in the frequency of vaginal examinations and further disrupting the balance of normal vaginal flora, weakening the immune system, and increasing the opportunity for pathogenic microorganisms to enter the vagina, blood, uterine cavity, and abdominal cavity through wounds in the reproductive tract and leads to sepsis.…”

Factors Associated with Increased Risk of Urosepsis during Pregnancy and Treatment Outcomes, in a Urology Clinic

“…Within the existing literature, the majority of studies have taken a broad approach, encompassing all causes of sepsis in pregnant women [2][3][4][5], and very few have specifically examined the impact of urinary tract infections (UTIs), particularly febrile infections, on the development of sepsis and its consequences for both mother and child. Similarly, factors associated with the occurrence of sepsis have been studied regardless of the site of primary infection [2,6,7]. Studies examining pyelonephritis, with or without sepsis, commonly referred to as febrile UTIs [8], have predominantly centered on pyelonephritis as a causative factor for sepsis in pregnant women and its associated antibiotic treatment [9][10][11].…”