Prenatal sonography of placental abscess and prolonged antibiotic treatment for <i>Serratia marcescens</i> bacteremia

Mak, A.; Tang, Thomas; Lam, Kwok Wai; Kwok, Angie L M; Cheuk, Wah; Wu, Tak Chiu; Leung, Kwok

doi:10.1002/ccr3.1406

Cited by 2 publications

(3 citation statements)

References 10 publications

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“…Of the previous cases, S. marcescens infection during pregnancy has a poor prognosis, three had spontaneous abortions, one delivered a dead fetus, and three had live babies. Of the three cases that had live babies, one showed signs of chorioamnionitis[ 3 ], and two had placental abscesses on ultrasonography and continued the antibiotic treatment[ 4 , 5 ]. In our patient, however, no infection focus was found until after the spontaneous abortion, so deciding the duration of antibiotic treatment was difficult.…”

Section: Discussionmentioning

confidence: 99%

Chorioamnionitis caused by Serratia marcescens in a healthcare worker: A case report

Park

Kim

Park

et al. 2021

WJCC

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BACKGROUND Healthcare workers (HCWs) are at an increased risk for exposure to infections. Serratia marcescens ( S . marcescens ) is a gram-negative, opportunistic and nosocomial pathogen belonging to the Enterobacterieae family. A few case reports have been published of chorioamnionitis caused by S. marcescens infection. Immunological changes during pregnancy can also affect the risk of infection. However, few studies have examined hospital-acquired bacterial infection in pregnant HCWs. CASE SUMMARY A 33-year-old woman, a resident in anesthesiology, was admitted at 14 wk gestation for fever with chills. She had no medical history other than contact dermatitis of both hands that started from the beginning of the trainee. There was no obvious infection focus and no bacterial growth in blood cultures. She was discharged after 1 wk of empirical antibiotic treatment. At three weeks before the fever started, she had a blister on the site of contact dermatitis on both hands, she applied antibiotic ointment for three days and the blisters had healed. At 19 wk gestation, she had a high fever and was readmitted. Physical examination and image studies were nonspecific and the patient had no other symptoms. S. marcescens grew in blood cultures at 19 wk gestation. Treatment with intravenous antibiotics was started. However, she suffered a miscarriage at 22 4/7 wk gestation. Pathologically, the amniotic membrane showed chorioamnionitis with a focal infarct. Subsequently, a placenta tissue culture grew S. marcescens . CONCLUSION HCWs can be exposed to pathogens that can cause opportunistic infections such as S. marcescens . Pregnancy affects the immune system, making it susceptible to opportunistic infections. Therefore, pregnant HCWs may require more preventive measures, including hand hygiene and avoid risk factors (ex. wrapping the skin).

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Section: Discussionmentioning

confidence: 99%

Chorioamnionitis caused by Serratia marcescens in a healthcare worker: A case report

Park

Kim

Park

et al. 2021

WJCC

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“…In some cases, the growth and spread of the infection occurred from the vagina, which was confirmed by a vaginal swab [ 9 , 13 , 14 ]. S. marcescens is not part of the normal vaginal flora and is most commonly encountered as an opportunistic pathogen in nosocomial settings [ 21 ]. It is typically associated with the use of invasive devices or procedures (e.g., chorionic villus sampling, placement of a central venous line), repeated vaginal examinations after preterm prelabor rupture of membranes as well as with patients whose health is generally compromised [ 9 , 11 , 14 ].…”

Section: Discussionmentioning

confidence: 99%

“…Amniocentesis is very important in the diagnosis of chorioamnionitis. This invasive procedure is followed by risks of miscarriage and transmission of the infection to the fetus [ 21 ]. On the other hand, a negative result cannot completely exclude chorioamnionitis, especially at an early stage [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

Serratia marcescens as a cause of unfavorable outcome in the twin pregnancy

Kljakić

Milosavljević²,

Jovanović

et al. 2020

Open Medicine

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Several Serratia species are widely distributed in nature, but Serratia marcescens is the only species frequently isolated in hospitals. This pathogen is mainly responsible for nosocomial infection, mostly in immunocompromised hosts. A 26-year-old woman with a twin pregnancy, regularly controlled, was hospitalized at 24 + 5 weeks of gestation due to scant vaginal bleeding, lower abdominal pain, and body temperature up to 37.5°C. Gynecological examination revealed bleeding accompanied by dilatation of the cervix. The laboratory analyses revealed leukocytosis with elevated C-reactive protein (CRP). Treatment was initiated with intravenous antibiotic administration. After admission, fetal membranes spontaneously ruptured, and an extremely preterm dichorionic female twin birth occurred at 25 + 0 weeks of gestation. Both infants died two days after labor. Pathological and microbiological analyses revealed chorioamnionitis caused by S. marcescens. According to the antibiogram, antibiotic treatment was continued for the next 7 days. The examination of cervical and vaginal discharge samples was negative three days and two weeks after therapy. S. marcescens may cause spontaneous miscarriages and, in this important case, caused loss of discordant twins in an extremely preterm birth by an immunocompetent patient. Infection by S. marcescens cannot be excluded as a cause of discordant growth and needs to be confirmed by further research.

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Prenatal sonography of placental abscess and prolonged antibiotic treatment for Serratia marcescens bacteremia

Cited by 2 publications

References 10 publications

Chorioamnionitis caused by Serratia marcescens in a healthcare worker: A case report

Chorioamnionitis caused by Serratia marcescens in a healthcare worker: A case report

Serratia marcescens as a cause of unfavorable outcome in the twin pregnancy

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