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A Murine Model of Group B Streptococcus Vaginal Colonization
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Peripartum bacteremia in the era of group B streptococcus prophylaxis

Alison Cape1, Ruth E Tuomala, Chirisse Taylor

  • 1Brigham and Women's Hospital, Division of Maternal-Fetal Medicine, and Channing Laboratory and Department of Newborn Medicine,Harvard Medical School, and the Division of Newborn Medicine, Children's Hospital, Boston, Massachusetts.

Obstetrics and Gynecology
|May 3, 2013
PubMed

Insights

In the era of group B streptococcus prophylaxis, Escherichia coli and enterococci are the most common causes of maternal bacteremia. Group B streptococcus is now rare, accounting for only 4% of peripartum infections.

Area of Science:

  • Obstetrics and Gynecology
  • Infectious Diseases
  • Microbiology

Background:

  • Peripartum bacteremia poses significant risks to maternal health.
  • Group B Streptococcus (GBS) prophylaxis has altered the landscape of peripartum infections.
  • Understanding current microbial epidemiology is crucial for effective management.

Purpose of the Study:

  • To define the microbial epidemiology of peripartum bacteremia.
  • To identify clinical risk factors associated with peripartum bacteremia.
  • To assess the impact of GBS prophylaxis on causative pathogens.

Main Methods:

  • Retrospective cohort study of maternal bacteremia from 2000-2008.
  • Inclusion criteria: peripartum period (7 days pre- to 30 days post-delivery).
  • Chart review to determine clinical factors and outcomes.

Main Results:

  • 172 cases of peripartum bacteremia identified (2.2 per 1,000 deliveries).
  • Most common pathogens: Escherichia coli (35.9%), enterococci (23.6%), and anaerobes (9.2%).
  • GBS accounted for only 4.1% of isolates; endometritis was the most common diagnosis (56%).

Conclusions:

  • E. coli and enterococci are now the predominant pathogens in peripartum bacteremia.
  • GBS is a rare cause of peripartum bacteremia in the era of prophylaxis.
  • Cesarean delivery and preterm birth are significant risk factors for endometritis-associated bacteremia.
Abstract

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