Management of infections during pregnancy and puerperium

Klooster, J. M. Van Der; Roelofs, H.J.M.

doi:10.1016/s0300-2977(97)00037-5

Cited by 16 publications

(11 citation statements)

References 13 publications

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“…Immunocompromised individuals are at high risk for bacteremia and systemic spread (26). Complications in pregnancy due to Salmonella infections include endomyometritis, salpingitis, chorioamnionitis, transplacental infection and septic abortion, neonatal septicemia, and meningitis, and there are a few reported cases of life-threatening septicemia in the mother (9,27). Abortions due to Salmonella serovars is also common in live stock, leading to huge economic losses (11).…”

Section: Discussionmentioning

confidence: 99%

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Pregnancy Impairs the Innate Immune Resistance toSalmonella typhimuriumLeading to Rapid Fatal Infection

Pejčić-Karapetrović

Gurnani

Russell

et al. 2007

The Journal of Immunology

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Typhoid fever and gastroenteritis caused by Salmonella enterica species are increasing globally. Pregnancy poses a high risk, but it is unclear how maternal immunity to infection is altered. In mice, susceptible strains die of S. enterica serovar typhimurium (ST) infection within 7 days whereas resistant mice (129×1/SvJ) develop a chronic infection. We found that virulent ST infection during pregnancy, in normally resistant 129×1/SvJ mice, evoked ∼100% fetal loss and surprisingly >60% host fatality, with a median survival of 6 days. Splenic bacterial load was 1000-fold higher in pregnant mice. This correlated to a diminished splenic recruitment/expansion of innate immune cells: dendritic cells, neutrophils, and NK cells. In particular, the splenic expansion and activation of NK cells postinfection seen in nonpregnant mice was lacking in pregnancy. Most notably, pregnant-infected mice had decreased production of serum IL-12 and increased IL-6 levels. Moreover, uteroplacental tissue of pregnant-infected mice exhibited an ∼40-fold increase in IL-6 mRNA expression relative to noninfected placenta, whereas IL-12p40 was not increased. In vivo blocking of IL-6 significantly reduced the splenic bacterial burden in pregnant mice yet failed to prevent fetal loss. Fetal demise correlated to the rapidity of infection; by 14 h, ST expanded to >105 in the placenta and had reached the fetus. Therefore, the preferential placental expansion of ST plausibly altered the inflammatory response toward IL-6 and away from IL-12, reducing the recruitment/activation of splenic innate immune cells. Thus, highly virulent pathogens may use placental invasion to alter systemic host resistance to infection.

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Section: Discussionmentioning

confidence: 99%

“…In humans, the high-risk populations for Salmonella infections include the young, old, pregnant, transplant patients, and HIVinfected individuals (9,10). Salmonella serovars also lead to pregnancy loss in livestock (11).…”

mentioning

confidence: 99%

Pregnancy Impairs the Innate Immune Resistance toSalmonella typhimuriumLeading to Rapid Fatal Infection

Pejčić-Karapetrović

Gurnani

Russell

et al. 2007

The Journal of Immunology

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“…Hastalık en sık görülen klinik formu olan gastroenterit tablosu ile seyredebileceği gibi tifoid ateş, septisemi, lokal enfeksiyonlar ve asemptomatik taşıyıcılık şeklinde de görülebilir. 8,9 Hastalığın inkübasyon süresi birkaç günden birkaç aya kadar değişebilir ve en sık izlenilen yaş dönemi ikinci ve üçüncü dekadlardır. 10 Başvuru anında tespit edilen şikâyetler; ateş yüksekliği, hâlsizlik, artralji, iştahsızlık, abdominal ağrı, diyare ve kabızlık şeklindedir.…”

Section: Discussionunclassified

“…ise demirin Salmonella enfeksiyonlarında hücre çoğalmasında tetikleyici rol aldığını ve gebelik döneminde replase edilen demir preparatları ile Salmonella enfeksiyonlarına yatkınlığın arttığını ileri sürmüşlerdir. 8 Hastalığın kliniği bu dönemde erken gebelik kayıplarına, postpartum septisemiye, endometrit, salpenjit, koryoamniyonit, transplasental enfeksiyonlar, neonatal septisemi ve menenjit gibi geniş bir yelpazeye sahiptir. Parson, yaptığı bildiride gebelik döneminde enterik ateş tanısı almış 64 olgunun irdelemesinde maternal mortalite oranını %25, prematüre doğum oranını ise %78,12 olarak bildirmiştir.…”

Section: Discussionunclassified

Typhoid Fever During Puerperium: Case Report and Review of the Literature

Uğuz¹,

Erdoğan²,

Yengel³

2015

Turkiye Klinikleri J Case Rep

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“…It is well established that a number of zoonotic pathogens, including Toxoplasma gondii, Listeria monocytogenes, certain Chlamydia species, and Coxiella burnetii, may constitute a risk for the pregnant woman and her fetus [1][2][3][4][5][6][7]. By contrast, pregnancy outcome following other zoonotic infections including Salmonella, Campylobacter, Yersinia enterocolitica and Brucella is more sparsely described [8][9][10][11][12][13].…”

Section: Introductionmentioning

confidence: 99%

Risk of adverse pregnancy outcome in women exposed to livestock: a study within the Danish National Birth Cohort

et al. 2013

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SUMMARYMaternal infection in pregnancy is a known risk factor for adverse pregnancy outcome, and a number of zoonotic pathogens may constitute a risk to pregnant women and their fetuses. With animal contact as a proxy for the risk of zoonotic infection, this study aimed to evaluate pregnancy outcome in women with self-reported occupational or domestic contact with livestock compared to pregnant women without such contact. The Danish National Birth Cohort collected information on pregnancy outcome from 100 418 pregnant women (1996)(1997)(1998)(1999)(2000)(2001)(2002) from which three study populations with occupational and/or domestic exposure to livestock and a reference group of women with no animal contact was sampled. Outcome measures were miscarriage, very preterm birth (before gestational week 32), preterm birth (before 37 gestational weeks), small for gestational age (SGA), and perinatal death. Adverse reproductive outcomes were assessed in four different exposure groups of women with occupational or domestic exposure to livestock with no association found between exposure to livestock and miscarriage, preterm birth, SGA or perinatal death. These findings should diminish general occupational health concerns for pregnant women with exposures to a range of different farm animals.

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Management of infections during pregnancy and puerperium

Cited by 16 publications

References 13 publications

Pregnancy Impairs the Innate Immune Resistance toSalmonella typhimuriumLeading to Rapid Fatal Infection

Pregnancy Impairs the Innate Immune Resistance toSalmonella typhimuriumLeading to Rapid Fatal Infection

Typhoid Fever During Puerperium: Case Report and Review of the Literature

Risk of adverse pregnancy outcome in women exposed to livestock: a study within the Danish National Birth Cohort

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