Youngest survivor of perinatal infection by Eikenella corrodens : case analysis and literature review highlighting the merits of placental swab culture

Abstract

Eikenella corrodens has been noted as a causative organism in both neonatal and perinatal sepsis. Positivity of blood cultures at birth among preterm infants may be influenced by the maternal use of peripartum antimicrobials and a normal C-reactive protein result within the first 24 hours need not always reflect the absence of fetal invasion by the highly pathogenic organisms. For these reasons, supportive and adjunctive approaches such as appropriately collected placental swabs for culture would be of value in optimizing the antimicrobial choice for sick preterm infants during the early neonatal period. Fetal infection by E. corrodens detected by placental swab culture influencing antimicrobial management of an extremely premature infant with sepsis is described. Management of the youngest premature survivor with the lowest birthweight among the reported cases in English language of neonatal E. corrodens infection is summarized and literature is reviewed. The value of placental swab, which is often underused, is highlighted in this review.

The microbial pathology of maternal perinatal sepsis: A single-institution retrospective five-year review

“…Pathogens cultured on the foetal side of the placenta are often correlated with early-onset neonatal sepsis severity [ 47 ]. Certainly, placental swab culture findings provide useful clinical information for neonatologists to inform antibiotic therapy, especially where blood cultures are sterile [ 32 ].…”

“…University Maternity Hospital Limerick (UMHL) is the only maternity hospital in the region, with circa 4,500 live births per annum. Previous related research from our institution includes a neonatal case study and literature review highlighting the merits of placental swab cultures [ 32 ], a number of neonatal [ 37 , 38 ] and other [ 39 , 40 ] outbreak reports, and a retrospective review of the time–to- positivity of neonatal blood cultures [ 41 ].…”

“…Placental swab cultures have been reported as useful in guiding antimicrobial therapy for the neonate [32][33][34], although this is not accepted universally [35,36]. There are limited data available describing the merits of placental swab cultures for the investigation of maternal sepsis, despite their inclusion in international guidelines [29,31]; and there is no uniformity in collection procedures for maternity hospitals nationally.…”