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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 
ORCID: https://orcid.org/0000-0003-2425-9394, Shakoor, Sadia, Gadama, Luis, Assarag, Bouchra, Souza, João Paulo and Cecatti, Jose G.
(2024)
'Aetiology and use of antibiotics in pregnancy-related infections: results of the WHO Global Maternal Sepsis Study (GLOSS), 1-week inception cohort'. Annals of Clinical Microbiology and Antimicrobials, Vol 23, Issue 1.
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12941_2024_Article_681.pdf - Published Version Available under License Creative Commons Attribution. Download (1MB) | Preview |
Abstract
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.
| Item Type: | Article |
|---|---|
| Subjects: | WA Public Health > Health Problems of Special Population Groups > WA 309 Women's health WC Communicable Diseases > Infection. Bacterial Infections > Bacterial Infections > WC 240 Bacteremia. Sepsis. Toxemias WQ Obstetrics > Pregnancy > WQ 200 General works WQ Obstetrics > Pregnancy Complications > WQ 240 Pregnancy complications (General) |
| Faculty: Department: | Clinical Sciences & International Health > Clinical Sciences Department |
| Digital Object Identifer (DOI): | https://doi.org/10.1186/s12941-024-00681-8 |
| SWORD Depositor: | JISC Pubrouter |
| Depositing User: | JISC Pubrouter |
| Date Deposited: | 26 Feb 2024 11:03 |
| Last Modified: | 26 Feb 2024 11:03 |
| URI: | https://archive.lstmed.ac.uk/id/eprint/24087 |
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