Volume 4 Supplement 1

20th International Symposium on Intensive Care and Emergency Medicine

Open Access

Bacteremia and systemic inflammatory response syndrome (SIRS) in confirmed post-partum endometritis

  • P Myrianthefs1,
  • K Varvaresou1,
  • C Ladakis1,
  • S Pactitis1,
  • V Lappas1,
  • J Stamatiou1,
  • A Carousou1,
  • J Pavlides1 and
  • J Baltopoulos1
Critical Care20004(Suppl 1):P77

https://doi.org/10.1186/cc797

Published: 21 March 2000

Full text

Background

Postpartum endometritis is the most common infectious complication of pregnancy, which has a serious impact on women's health and can lead to severe sepsis.

Material and methods

We encountered 150 women with clinical evidence of early (1–48 h) post-partum endometritis and SIRS (fever, tachycardia, tachypnea and increased white blood cell count and C-reactive protein) after either vaginal delivery or caesarian section. We obtained blood cultures (aerobic and anaerobic) at 38.5°C and before administration of antibiotics.

Results

Fifteen samples (10%) were positive proving bacteremia of which 12 (80%) were indicative of aerobic and 3 (20%) of anaerobic bacteria. There were also 7 cases of contamination due to Staphylococcus epidermidis. Isolated aerobic Gram negative bacteria (10/15, 66.6%) were Escherichia coli (6), Pseudomonas cepacia (1), Enterobacter aerogenes (1), Salmonella group C (1), Klebsiella pneumoniae (1) and Gram positive cocci (2/15, 13.3%) were Enterococcus faecalis (1) and Streptococcus group A (1). Anaerobic bacteria (3/15, 20%) were Bacteroides fragilis (2) and Clostridium sp (1). All patients were treated empirically until antibiotic sensitivity tests were available with ceftriaxone 2 gr×1 iv, netilmicin 300 mg×1 iv and metronidazole 500 mg×3 iv. Outcome was successful in all patients. None of the isolated bacteria was multi-drug resistant.

Conclusion

Bacteremia in early post-partum endometritis was confirmed in 10% of cases. Isolated bacteria were similar to those referred to in the literature (80% Gram negative bacteria, 20% Gram positive and anaerobic bacteria). Early recognition and appropriate management ensures successful outcome and prevention of complications such as severe sepsis.

Authors’ Affiliations

(1)
Department of Intensive Care Unit, "IASO" Maternity Hospital

Copyright

© Current Science Ltd 2000

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