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.
© 2024. The Author(s).
Overview publication
| Title | Aetiology and use of antibiotics in pregnancy-related infections: results of the WHO Global Maternal Sepsis Study (GLOSS), 1-week inception cohort. |
| Date | February 24th, 2024 |
| Issue name | Annals of clinical microbiology and antimicrobials |
| Issue number | v23.1:21 |
| DOI | 10.1186/s12941-024-00681-8 |
| PubMed | 38402175 |
| Authors | |
| Info | WHO GLOSS research group, Aman MI, Noormal B, Díaz V, Espinoza M, Pasquale J, Leroy C, Roelens K, Vandenberghe G, Christian Urlyss Agossou M, Keke SG, Aguemon CT, Peralta PSA, Altamirano VC, Muñoz RH, Cecatti JG, Ribeiro-Do-Valle CC, Batiene V, Cisse K, Ouedraogo HG, Kannitha C, Phirun L, Rathavy T, Simo E, Tebeu PM, Yakana EI, Carvajal J, Escobar MF, Fernández P, Colmorn LB, Langhoff-Roos J, Mereci W, Vélez P, Eldin YS, Sultan A, Abdosh AA, Teklu AM, Kassa DW, Adanu R, Govule P, Lwanga CN, Romero WEA, Aceituno MGF, Bustillo C, Castro R, Lara B, Kumar V, Suri V, Trikha S, Cetin I, Donati S, Personeni C, Baimussanova G, Kabylova S, Sagyndykova B, Gwako G, Osoti A, Qureshi Z, Asylbasheva R, Boobekova A, Seksenbaeva D, El Kak F, Itani SE, Malham SA, Minkauskienė M, Ramašauskaitė D, Chikhwaza O, Malunga E, Dembele H, Sangho H, Zerbo FE, Serapio FD, Maldonado NH, Castañeda JII, Caraus T, Curteanu A, Petrov V, Buyanjargal Y, Khishgee S, Lkhagvasuren BE, Essolbi A, Moulki R, Osman NB, Jaze Z, Mariano A, Einda HMT, Maung TM, Tin KN, Gurung T, Shrestha AB, Shrestha S, Bloemenkamp K, Rijken MJ, Van Den Akker T, Estrada ME, Pavón NJG, Adesina O, Aimakhu C, Fawole B, Chaudhri R, Hamid S, Adnan Khan M, Del Huatuco PilarHernández M, Zavaleta NMP, Andal ML, Martin CP, Recidoro ZD, Budianu MA, Puşcaşiu L, Diouf L, Guirassy D, Moreira PM, Borovsky M, Kovac L, Kristufkova A, Cebekhulu S, Cornelissen L, Soma-Pillay P, Cararach V, López M, Benedé MJV, Jayakody H, Jayaratne K, Rowel D, Elsheikh M, Nabag W, Omer S, Tsoy V, Uzakova U, Yunusova D, Siriwachirachai T, Tangsiriwatthana T, Pérez AM, Roman J, Vitureira G, Tuan DA, Truong LN, Hanh NTX, Madziyire M, Magwali T, Munjanja S, Chamillard M, Fawole B, Kouanda S, Lumbiganon P, Nabhan A, Nadisauskiene R, Bartlett L, Jacob ST, Yunis K, Campodónico L, Cuesta C, Gamerro H, Giordano D, Althabe F, Metin Gülmezoglu A |
| Keywords | Antibiotic, Infections, Maternal morbidity, Maternal sepsis |
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