학술논문
Aetiology and use of antibiotics in pregnancy-related infections: results of the WHO Global Maternal Sepsis Study (GLOSS), 1-week inception cohort
Document Type
Report
Author
Ribeiro-do-Valle, Carolina C.; Bonet, Mercedes; Brizuela, Vanessa; Abalos, Edgardo; Baguiya, Adama; Bellissimo-Rodrigues, Fernando; Budianu, Mihaela; Puscasiu, Lucian; Knight, Marian; Lissauer, David; Dunlop, Catherine; Jacob, Shevin T.; Shakoor, Sadia; Gadama, Luis; Assarag, Bouchra; Souza, João Paulo; Cecatti, Jose G.; Aman, Mohammad Iqbal; Noormal, Bashir; Díaz, Virginia; Espinoza, Marisa; Pasquale, Julia; Leroy, Charlotte; Roelens, Kristien; Vandenberghe, Griet; Christian Urlyss Agossou, M.; Keke, Sourou Goufodji; Aguemon, Christiane Tshabu; Peralta, Patricia Soledad Apaza; Altamirano, Víctor Conde; Muéoz, Rosalinda Hernández; Cecatti, José Guilherme; Ribeiro-Do-Valle, Carolina C.; Batiene, Vincent; Cisse, Kadari; Ouedraogo, Henri Gautier; Kannitha, Cheang; Phirun, Lam; Rathavy, Tung; Simo, Elie; Tebeu, Pierre-Marie; Yakana, Emah Irene; Carvajal, Javier; Escobar, María Fernanda; Fernández, Paula; Colmorn, Lotte Berdiin; Langhoff-Roos, Jens; Mereci, Wilson; Vélez, Paola; Eldin, Yasser Salah; Sultan, Alaa; Abdosh, Abdulfetah Abdulkadir; Teklu, Alula M.; Kassa, Dawit Worku; Adanu, Richard; Govule, Philip; Lwanga, Charles Noora; Romero, William Enrique Arriaga; Aceituno, María Guadalupe Flores; Bustillo, Carolina; Castro, Rigoberto; Lara, Bredy; Kumar, Vijay; Suri, Vanita; Trikha, Sonia; Cetin, Irene; Donati, Serena; Personeni, Carlo; Baimussanova, Guldana; Kabylova, Saule; Sagyndykova, Balgyn; Gwako, George; Osoti, Alfred; Qureshi, Zahida; Asylbasheva, Raisa; Boobekova, Aigul; Seksenbaeva, Damira; El Kak, Faysal; Itani, Saad Eddine; Malham, Sabina Abou; MinkauskienÄ, MeilÄ; RamaÅ¡auskaitÄ, Diana; Chikhwaza, Owen; Malunga, Eddie; Dembele, Haoua; Sangho, Hamadoun; Zerbo, Fanta Eliane; Serapio, Filiberto Dávila; Maldonado, Nazarea Herrera; Castaéeda, Juan Ismael Islas; Caraus, Tatiana; Curteanu, Ala; Petrov, Victor; Buyanjargal, Yadamsuren; Khishgee, Seded; Lkhagvasuren, Bat-Erdene; Essolbi, Amina; Moulki, Rachid; Osman, Nafissa Bique; Jaze, Zara; Mariano, Arlete; Einda, Hla Mya Thway; Maung, Thae Maung; Tin, Khaing Nwe; Gurung, Tara; Shrestha, Amir Babu; Shrestha, Sangeeta; Bloemenkamp, Kitty; Rijken, Marcus J; Van Den Akker, Thomas; Estrada, María Esther; Pavón, Néstor J. Gómez; Adesina, Olubukola; Aimakhu, Chris; Fawole, Bukola; Chaudhri, Rizwana; Hamid, Saima; Adnan Khan, M.; del Huatuco PilarHernández, María; Zavaleta, Nelly M. Pimentel; Andal, Maria Lu; Martin, Carolina Paula; Recidoro, Zenaida Dy; Budianu, Mihaela-Alexandra; PuÅcaÅiu, Lucian; Diouf, Léopold; Guirassy, Dembo; Moreira, Philippe Marc; Borovsky, Miroslav; Kovac, Ladislav; Kristufkova, Alexandra; Cebekhulu, Sylvia; Cornelissen, Laura; Soma-Pillay, Priya; Cararach, Vicenç; López, Marta; Benedé, María José Vidal; Jayakody, Hemali; Jayaratne, Kapila; Rowel, Dhammica; Elsheikh, Mohamed; Nabag, Wisal; Omer, Sara; Tsoy, Victoria; Uzakova, Urunbish; Yunusova, Dilrabo; Siriwachirachai, Thitiporn; Tangsiriwatthana, Thumwadee; Pérez, Aquilino M.; Roman, Jhon; Vitureira, Gerardo; Tuan, Dinh Anh; Truong, Luong Ngoc; Hanh, Nghiem Thi Xuan; Madziyire, Mugove; Magwali, Thulani; Munjanja, Stephen; Chamillard, Mónica; Kouanda, Seni; Lumbiganon, Pisake; Nabhan, Ashraf; Nadisauskiene, Ruta; Bartlett, Linda; Yunis, Khalid; Campodónico, Liana; Cuesta, Cristina; Gamerro, Hugo; Giordano, Daniel; Althabe, Fernando; Metin Gülmezoglu, A.
Source
Annals of Clinical Microbiology and Antimicrobials. February 24, 2024, Vol. 23 Issue 1
Subject
Language
English
ISSN
1476-0711
Abstract
Author(s): Carolina C. Ribeiro-do-Valle[sup.1] , Mercedes Bonet[sup.2] , Vanessa Brizuela[sup.2] , Edgardo Abalos[sup.3] , Adama Baguiya[sup.4] , Fernando Bellissimo-Rodrigues[sup.5] , Mihaela Budianu[sup.6] , Lucian Puscasiu[sup.6] , Marian Knight[sup.7] , David [...]
Background Pregnancy-related infections are important contributors to maternal sepsis and mortality. We aimed to describe clinical, microbiological characteristics and use of antibiotics by source of infection and country income, among hospitalized women with suspected or confirmed pregnancy-related infections. Methods We used data from WHO Global Maternal Sepsis Study (GLOSS) on maternal infections in hospitalized women, in 52 low-middle- and high-income countries conducted between November 28th and December 4th, 2017, to describe the frequencies and medians of maternal demographic, obstetric, and clinical characteristics and outcomes, methods of infection diagnosis and causative pathogens, of single source pregnancy-related infection, other than breast, and initial use of therapeutic antibiotics. We included 1456 women. Results We found infections of the genital (n = 745/1456, 51.2%) and the urinary tracts (UTI) (n = 531/1456, 36.5%) to be the most frequent. UTI (n = 339/531, 63.8%) and post-caesarean skin and soft tissue infections (SSTI) (n = 99/180, 55.0%) were the sources with more culture samples taken and microbiological confirmations. Escherichia coli was the major uropathogen (n = 103/118, 87.3%) and Staphylococcus aureus (n = 21/44, 47.7%) was the commonest pathogen in SSTI. For 13.1% (n = 191) of women, antibiotics were not prescribed on the same day of infection suspicion. Cephalosporins (n = 283/531, 53.3%) were the commonest antibiotic class prescribed for UTI, while metronidazole (n = 303/925, 32.8%) was the most prescribed for all other sources. Ceftriaxone with metronidazole was the commonest combination for the genital tract (n = 98/745, 13.2%) and SSTI (n = 22/180, 12.2%). Metronidazole (n = 137/235, 58.3%) was the most prescribed antibiotic in low-income countries while cephalosporins and co-amoxiclav (n = 129/186, 69.4%) were more commonly prescribed in high-income countries. Conclusions Differences in antibiotics used across countries could be due to availability, local guidelines, prescribing culture, cost, and access to microbiology laboratory, despite having found similar sources and pathogens as previous studies. Better dissemination of recommendations in line with antimicrobial stewardship programmes might improve antibiotic prescription. Keywords: Maternal sepsis, Maternal morbidity, Infections, Antibiotic
Background Pregnancy-related infections are important contributors to maternal sepsis and mortality. We aimed to describe clinical, microbiological characteristics and use of antibiotics by source of infection and country income, among hospitalized women with suspected or confirmed pregnancy-related infections. Methods We used data from WHO Global Maternal Sepsis Study (GLOSS) on maternal infections in hospitalized women, in 52 low-middle- and high-income countries conducted between November 28th and December 4th, 2017, to describe the frequencies and medians of maternal demographic, obstetric, and clinical characteristics and outcomes, methods of infection diagnosis and causative pathogens, of single source pregnancy-related infection, other than breast, and initial use of therapeutic antibiotics. We included 1456 women. Results We found infections of the genital (n = 745/1456, 51.2%) and the urinary tracts (UTI) (n = 531/1456, 36.5%) to be the most frequent. UTI (n = 339/531, 63.8%) and post-caesarean skin and soft tissue infections (SSTI) (n = 99/180, 55.0%) were the sources with more culture samples taken and microbiological confirmations. Escherichia coli was the major uropathogen (n = 103/118, 87.3%) and Staphylococcus aureus (n = 21/44, 47.7%) was the commonest pathogen in SSTI. For 13.1% (n = 191) of women, antibiotics were not prescribed on the same day of infection suspicion. Cephalosporins (n = 283/531, 53.3%) were the commonest antibiotic class prescribed for UTI, while metronidazole (n = 303/925, 32.8%) was the most prescribed for all other sources. Ceftriaxone with metronidazole was the commonest combination for the genital tract (n = 98/745, 13.2%) and SSTI (n = 22/180, 12.2%). Metronidazole (n = 137/235, 58.3%) was the most prescribed antibiotic in low-income countries while cephalosporins and co-amoxiclav (n = 129/186, 69.4%) were more commonly prescribed in high-income countries. Conclusions Differences in antibiotics used across countries could be due to availability, local guidelines, prescribing culture, cost, and access to microbiology laboratory, despite having found similar sources and pathogens as previous studies. Better dissemination of recommendations in line with antimicrobial stewardship programmes might improve antibiotic prescription. Keywords: Maternal sepsis, Maternal morbidity, Infections, Antibiotic