Neonatal and maternal postpartum bacteroides bacteremia

A unique case of Bacteroides fragilis bacteremia in a mother and her infant prompted a review of these infections in neonates and postpartum mothers during a five-year period at two institutions in Winnipeg, Manitoba. The purpose was to determine the frequency of these infections and ascertain commonly associated factors.

Infants and postpartum mothers diagnosed with bacteroides bacteremia were identified from laboratory records in both hospitals, and their medical charts were retrospectively reviewed.

Bacteroides species were isolated in 10 maternal and four neonatal blood cultures. This represented 8.1% of the positive maternal and 1.2% of the positive neonatal blood cultures obtained during the review. The incidence of maternal infection was 2.56/10,000 deliveries, while that of neonatal infection was 1.03/10,000 live births. Postpartum fever and emergency caesarean section were often noted with maternal postpartum bacteroides bacteremia, while fetal distress, low Apgar scores and respiratory distress were frequent in neonatal bacteremia.

Postpartum bacteroides bacteremia should be suspected among women with postpartum fever after emergency caesarean section. However, the occurrence of postpartum fever following emergency caesarian section is not necessarily associated with neonatal bacteroides bacteremia. Neonatal bacteroides bacteremia may not be readily suspected on clinical grounds, so clinicians should ensure that the laboratory procedures routinely used to evaluate neonatal bacteremia at their institutions reliably detect these organisms.