Vaginal Bacteroides species are associated with an increased rate of preterm delivery among women in preterm labor

Article Abstract:

Bacterial infection with Neisseria gonorrhoeae, Chlamydia trachomatis, Trichomonas vaginalis, Ureaplasma urealyticum, group B streptococci, Gardnerella vaginalis, and Bacteroides species, may cause premature labor, preterm delivery, and preterm rupture of fetal membranes. Most of these infections are sexually transmitted. There is little information about the effects of increased levels of endogenous vaginal bacteria (which normally inhabit the vagina) on preterm labor or preterm delivery. The effects of high amounts of vaginal microorganisms on the incidence (number of new cases) of premature delivery were assessed in 211 women between 22 and 34 weeks of pregnancy, who were experiencing preterm labor. Studies have shown that neonatal death and disability, and inflammation and infection of the fetal membranes occurs most often in pregnancies that are delivered before the 35 week. Samples of vaginal tissue were obtained for culture, a procedure in which the tissue is exposed to conditions that enhance bacterial growth. If bacteria can be identified after culture of the tissue, the patient is considered to be infected. Of 211 pregnancies with preterm labor, 139 ended in preterm delivery. The incidence of preterm delivery was decreased by 40 percent among the women with high levels of facultative lactobacilli in the vaginal fluid, but increased among women with high levels of Bacteroides bivius and B. fragilis. An increased incidence of premature delivery in women experiencing premature labor was not associated with vaginal infection by Gardnerella vaginalis, genital mycoplasmas, group B streptococci, Escherichia coli, and Peptostreptococcus species. (Consumer Summary produced by Reliance Medical Information, Inc.)

Infection, Complications and side effects, Risk factors, Pregnant women, Childbirth, Delivery (Childbirth), Premature labor, Premature birth, Vagina, Bacterial vaginitis

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Prevalence of antibiotic-resistant uropathogens in obstetric patients with acute pyelonephritis

Article Abstract:

Acute pyelonephritis, an infection of the kidneys, is commonly seen in women and occurs in approximately one to two percent of pregnant patients. Ampicillin has been the drug of choice in many hospitals; however, many organisms are becoming increasingly resistant to this antibiotic. Drug resistance patterns in the hospital setting are often derived from observations of a drug's effectiveness in seriously ill and immunocompromised patients, and the true risk of resistance to ampicillin in obstetric patients with acute pyelonephritis may be lower. The common uropathogens (urinary organisms) responsible for acute pyelonephritis and the antibiotic sensitivity to these organisms were studied in 121 pregnant patients. The most common organism was Escherichia coli, which was identified in 80 percent of patients, while the other organisms isolated were Klebsiella pneumoniae, Proteus mirabilis, and Staphylococcus aureus. Antibiotic resistance to ampicillin was seen in 26 percent of cases over a four-year period. Only four percent of the uropathogens were resistant to cephapirin, which belongs to the class of antibiotics called first-generation cephalosporins. All isolates of E. coli and K. pneumoniae were sensitive to cephalosporins. There were only three patients who did not respond to treatment with the cephalosporin, for whom a change in therapy was necessary. The difference in antibiotic sensitivity was statistically significant. A first-generation cephalosporin such as cephapirin is considered a better choice for the treatment of acute pyelonephritis. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Evaluation, Statistics, Drug therapy, Drug resistance in microorganisms, Microbial drug resistance, Bacterial infections, Pyelonephritis, Cephalosporins

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