Journal of Shandong University (Health Sciences) ›› 2022, Vol. 60 ›› Issue (1): 48-54.doi: 10.6040/j.issn.1671-7554.0.2021.0516

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Clinical characteristics and placental pathology of bloodstream infection in 50 pregnant women

LI Yan1, LIU Jing1, LI Juan2, YANG Qiuhong1   

  1. 1. Department of Obstetrics and Gynecology;
    2. Department of Pathology, Jinan Maternity and Child Care Hospital, Jinan 250001, Shandong, China
  • Published:2022-01-08

Abstract: Objective To analyze the clinical characteristics and placental pathology of bloodstream infection in pregnant women. Methods A total of 50 pregnant women with bloodstream infection during Aug. 1, 2016 and Aug. 1, 2020 were selected as the bloodstream infection group, and another 50 pregnant women without blood stream infection were selected as the control group. The age, delivery mode, infection time, application of special antibiotics, fetal distress, stillbirth, abortion, premature delivery, neonatal infection, septic shock, maternal death, placenta maternal inflammatory reaction, placenta fetal inflammatory reaction and other indicators were analyzed. The pathogenic bacteria isolated from blood culture in the bloodstream infection group were collected, the distribution of pathogenic bacteria was analyzed, and the drug sensitivity results of the pathogenic bacteria with the highest detection rate were analyzed. Results The use of special antibiotics in the bloodstream infection group was higher than that in the control group(P<0.001). The bloodstream infection group had higher probability of septic shock(P=0.041), premature delivery(P=0.007), abortion(P=0.012), stillbirth(P=0.041), neonatal infection(P=0.022), placental maternal inflammation(P=0.006)and placental fetal inflammation(P=0.003)than the control group. The top 6 pathogenic bacteria were Escherichia coli(50%), Listeria(10%), Enterococcus faecalis(8%), Streptococcus pyogenes(6%), Streptococcus agalactiae(4%), Staphylococcus aureus(4%). Escherichia coli was sensitive to cefoxitin, ceftazidime, tobramycin, and ampicillin/sulbactam(≥80%). The sensitivity rates to meropenem, imipenem, amikacin, cefoperazone/sulbactam, piperacillin/tazobactam and ticacillin/clavulanate were over 95%. Conclusion Bloodstream infection seriously threatens the life and health of mothers and children. Escherichia coli has the highest infection rate, and Streptococcus pyogenes and Listeria also have serious harm to mothers and children. For pregnant women with fever, early standardized blood culture and targeted selection of sensitive antibiotics can improve the prognosis and reduce the mortality of mothers and children.

Key words: Bloodstream infection, Pregnancy, Pathogens, Drug resistance, Placental pathology

CLC Number: 

  • R714.7
[1] Lucas DN, Robinson PN, Nel MR. Sepsis in obstetrics and the role of the anaesthetist [J]. Int J Obstet Anesth, 2012, 21(1): 56-67.
[2] 刘平, 樊尚荣, 梁轶珩, 等. 41例妊娠期和产后脓毒症病例分析[J]. 中华产科急救电子杂志, 2018, 7(3): 174-179. LIU Ping, FAN Shangrong, LIANG Yiheng, et al. Analysis of 41 cases of sepsis during pregnancy and postpartum [J]. Chinese Journal of Obstetric Emergency(Electronic Edition), 2018, 7(3): 174-179.
[3] 凌利芬, 陆学东, 汤一苇. 血流感染的实验室诊断进展研究[J]. 中华医院感染学杂志, 2018, 28(14): 2234-2240. LING Lifen, LU Xuedong, TANG Yiwei. Advances in laboratory diagnosis of bloodstream infections [J]. Chinese Journal of Nosocomiology, 2018, 28(14): 2234-2240.
[4] 中华人民共和国卫生部. 医院感染诊断标准(试行)[J]. 中华医学杂志, 2001, 81(5): 314-320.
[5] 谢幸, 孔北华, 段涛. 妇产科学[M]. 9版. 北京: 人民卫生出版社, 2018:70-140.
[6] Khong TY, Mooney EE, Ariel I, et al. Sampling and definitions of placental lesions: amsterdam placental workshop group consensus statement [J]. Arch Pathol Lab Med, 2016, 140(7): 698-713.
[7] Burlinson CEG, Sirounis D, Walley KR, et al. Sepsis in pregnancy and the puerperium [J]. Int J Obstet Anesth, 2018, 36: 96-107. doi: 10.1016/j.ijoa.2018.04.010.
[8] Hensley MK, Bauer ME, Admon LK, et al. Incidence of maternal sepsis and sepsis-related maternal deaths in the United States [J]. JAMA,2019, 322(9): 890-892.
[9] Acosta CD, Knight M. Sepsis and maternal mortality [J]. Curr Opin Obstet Gynecol, 2013, 25(2): 109-116.
[10] 钟旋, 张温魔, 蔡双明. A组链球菌感染引起的中毒性休克综合征合并妊娠1例[J]. 广东医学, 2019, 40(23): 3361-3362. ZHONG Xuan, ZHANG Wenmo, CAI Shuangming. Toxic shock syndrome complicated with pregnancy caused by group A streptococcus infection: a case report [J]. Guangdong Medical Journal, 2019, 40(23): 3361-3362.
[11] 杨秋红, 宋敏, 孙谦, 等. 妊娠晚期链球菌中毒性休克综合征2例报道及文献复习[J]. 中华围产医学杂志, 2019, 22(12): 872-877. YANG Qiuhong, SONG Min, SUN Qian, et al. Streptococcal toxic shock syndrome in third trimester: a report of two cases and literature review [J]. Chinese Journal of Perinatal Medicine, 2019, 22(12): 872-877.
[12] 韩彤妍, 杨孜, 朴梅花. 绒毛膜羊膜炎与胎儿及新生儿疾病[J]. 中国实用妇科与产科杂志, 2016, 32(6): 529-534. HAN Tongyan, YANG Zi, PIAO Meihua. Chorioamnionitis and fetal and neonatal diseases [J]. Chinese Journal of Practical Gynecology and Obstetrics, 2016, 32(6): 529-534.
[13] 吴婷, 颜伟卉, 罗力冰, 等. 国内102例妊娠合并李斯特菌感染的临床分析[J]. 临床医药文献电子杂志, 2020, 7(52): 9-11. WU Ting, YAN Weihui, LUO Libing, et al. Clinical analysis of 102 cases of pregnancy complicated with listeria infection in China [J]. Journal of Clinical Medical Literature(Electronic Edition), 2020, 7(52): 9-11.
[14] 宋敏, 牟瑞丽, 张琳琳, 等. 妊娠合并单核李斯特菌感染7例临床分析[J]. 现代妇产科进展, 2021, 30(3): 200-203. SONG Min, MU Ruili, ZHANG Linlin, et al. A clinical analysis of 7 patients with maternal listeriosis [J]. Progress in Obstetrics and Gynecology, 2021, 30(3): 200-203.
[15] 冯轶, 周莉. 妊娠期李斯特菌感染的临床分析[J]. 北京医学, 2020, 42(12): 1249-1251. FENG Yi, ZHOU Li. Clinical analysis of listeria infection during pregnancy [J]. Beijing Medical Journal, 2020, 42(12): 1249-1251.
[16] 胡付品, 朱德妹, 汪复, 等. 2014年CHINET中国细菌耐药性监测[J]. 中国感染与化疗杂志, 2015(5): 401-410. HU Fupin, ZHU Demei, WANG Fu, et al. CHINET 2014 surveillance of bacterial resistance in China [J]. Chinese Journal of Infection and Chemotherapy, 2015(5): 401-410.
[17] 全国细菌耐药监测网. 全国细菌耐药监测网2014-2019年血标本病原菌耐药性变迁[J]. 中国感染控制杂志, 2021, 20(2): 124-133. China Antimicrobial Resistance Surveillance System. Change in antimicrobial resistance of pathogens from blood specimens: surveillance report from China Antimicrobial Resistance Surveillance System in 2014-2019 [J]. Chinese Journal of Infection Control, 2021, 20(2): 124-133.
[18] 周翠香, 折瑞莲, 张杰生, 等. 妊娠期及产褥期脓毒症的临床特点分析[J]. 中国临床研究, 2020, 33(9): 1235-1238. ZHOU Cuixiang, ZHE Ruilian, ZHANG Jiesheng, et al. Clinical characteristics of sepsis in pregnancy and puerperium [J]. Chinese Journal of Clinical Research, 2020, 33(9): 1235-1238.
[19] 马成云, 李波, 李文君, 等. 医院感染的预防和控制[J]. 中华医院感染学杂志, 2005, 15(5): 550-552. MA Chengyun, LI Bo, LI Wenjun, et al. Prevention and control of nosocomial infection [J]. Chinese Journal of Nosocomiology, 2005, 15(5): 550-552.
[20] 周先荣. 胎盘病理学检查的意义和基本原则[J]. 中华病理学杂志, 2020, 49(8): 779-781. ZHOU Xianrong. The significance and essential principles of placental pathology [J]. Chinese Journal of Pathology, 2020, 49(8): 779-781.
[21] Hockney R, Waring GJ, Taylor G, et al. Fetal membrane bacterial load is increased in histologically confirmed inflammatory chorioamnionitis: a retrospective cohort study [J]. Placenta, 2020, 91: 43-51. doi: 10.1016/j.placenta.2020.01.006.
[22] Kim CJ, Romero R, Chaemsaithong P, et al. Acute chorioamnionitis and funisitis: definition, pathologic features, and clinical significance [J]. Am J Obstet Gynecol, 2015, 213(4 Suppl): S29-S52.
[23] Rovira N, Alarcon A, Iriondo M, et al. Impact of histological chorioamnionitis, funisitis and clinical chorioamnionitis on neurodevelopmental outcome of preterm infants [J]. Early Hum Dev, 2011, 87(4): 253-257.
[24] 李娟, 尹燕雪, 赵澄泉, 等. 胎盘炎性病变的分类、病理特征及临床意义[J]. 中华病理学杂志, 2021, 50(3): 300-304. LI Juan, YIN Yanxue, ZHAO Chengquan, et al. Classification, pathological features and clinical significance of placental inflammatory lesions [J]. Chinese Journal of Pathology, 2021, 50(3): 300-304.
[25] 旷凌寒, 龚云辉, 苏敏, 等. 妊娠期李斯特菌病19例临床分析[J]. 中华妇产科杂志, 2017, 52(10): 657-661. KUANG Linghan, GONG Yunhui, SU Min, et al. Clinical analysis of 19 pregnancies complicated listeriosis [J]. Chinese Journal of Obstetrics and Gynecology, 2017, 52(10): 657-661.
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