Clinical and Pathogenic Characteristics of 45 Cases of Bloodstream Infection in Obstetrics: A Clinical Analysis

To investigate the clinical characteristics, pathogenic profile, and outcomes of pregnant and puerperal women bloodstream infections.

A retrospective analysis was conducted on the medical records of 45 pregnant women with positive blood cultures admitted to the First People's Hospital of Chenzhou from January 2018 to March 2025.

The positive rate of blood culture is 1.64‰. According to whether the bacteria are multi-drug resistant, they are divided into non multi-drug resistant group (25 cases) and multi drug resistant group (20 cases). There were statistically significant differences included vaginal delivery numbers (P=0.035), mid-to-late pregnancy induced abortion (P=0.036), placental abnormalities (P=0.036), ectopic pregnancy history (P=0.033), cough/sputum (P=0.012), non-cesarean uterine surgery (P=0.014), failed vaginal delivery to cesarean (P=0.025), and manual placental removal (P=0.027). Twenty-nine percent had uncertain infection sites. The top three bacteria are Escherichia coli, Enterococcus faecalis, and Staphylococcus epidermidis. Multi site or mixed infections account for 37.78%. The resistance rate to levofloxacin and cefuroxime exceeds 30%, while the resistance rate to ceftriaxone exceeds 40%. The resistance rates of piperacillin/tazobactam, imipenem, and meropenem are all 0.

In the event of bloodstream infection, there is a high possibility of infection with non-multidrug-resistant bacteria in patients with obvious cough/sputum symptoms, failed vaginal delivery to cesarean section, placental abnormalities, and artificial placental abruption; Patients with a history of ectopic pregnancy or who have undergone uterine surgery other than cesarean section during this pregnancy are more likely to be infected with multidrug-resistant bacteria. Notably, when infection and shock coexist, the cause of shock may not necessarily be infectious.