Chorioamnionitis and neonatal sepsis due to extended‐spectrum beta‐lactamase‐producing Escherichia coli infection: a case report

Abstract

Chorioamnionitis is an acute inflammation of the membranes and chorion of the placenta typically due to ascending polymicrobial infection in the setting of membrane rupture. It is a common complication of pregnancy associated with significant maternal, perinatal, and long‐term adverse outcomes. We present a case of placental infection leading to preterm delivery, severe neonatal sepsis, maternal wound infection, postnatal readmission, and prolonged hospital stay. This virulent infection was caused by multidrug–resistant extended‐spectrum beta‐lactamase (ESBL)‐producing Escherichia Coli (E. Coli), which represent a major worldwide threat according to the Centre for Disease Control and Prevention (CDC). It was managed with appropriate antibiotic therapy, patient‐centered approach, and multidisciplinary team involvement that led to favourable maternal and neonatal outcome.

Amp-CKlebsiella-Induced Chorioamnionitis and Associated Abnormalities in Cardiotocography: A Case Report with a Narrative Review

“…In a study by Shittu et al, poor maternal morbidity was noted in women with MDRO CA leading to maternal septicemia and wound infection. In their study, the patient had readmission with the same MDRO-induced surgical site infection which caused CA [ 5 ].…”

“…On the other hand, the absence of a cycling pattern and maternal tachycardia were associated with poor neonatal outcome [ 22 ]. In another case report, recurrent variable decelerations were noted with baseline tachycardia and poor variability with MDRO-induced CA [ 5 ]. Sukumaran et al reported an increase in baseline fetal heart rate and variable decelerations in women with CA [ 23 ].…”

“…In women with chorioamnionitis (CA) caused by MDRO, the diagnosis is often delayed due to atypical presentation and is associated with poor neonatal outcomes [ 5 ]. Once the diagnosis of CA is established, usually, broad-spectrum antibiotics are commenced.…”

“…Once the diagnosis of CA is established, usually, broad-spectrum antibiotics are commenced. However, due to antibiotic resistance in cases of CA caused by MDRO, maternal and neonatal morbidity is unexpectedly higher compared to usual CA cases [ 5 ]. In a review by Ballot et al (2019), a statistically significant rise in MRDO isolates from neonates was reported (0.39 in 2013 vs. 1.4 in 2015).…”

“…In a review by Ballot et al (2019), a statistically significant rise in MRDO isolates from neonates was reported (0.39 in 2013 vs. 1.4 in 2015). Maternal and neonatal outcomes are usually poor in these cases [ 5 , 6 ]. The prevalence of MDRO in neonates was reported as 8.8%, and mortality rate in these neonates was 33.3% [ 6 ].…”