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Efficacy of long-term co-trimoxazole in Q fever during pregnancy

Abstract number: 1733_732

Carcopino X., Raoult D., Boubli L., Stein A.

Background: Q fever is a worldwide zoonosis caused by the obligate intracellular bacterium Coxiella burnetii. During pregnancy it may result in obstetrical complications such as spontaneous abortion, low birth weight, oligoamnios, fetal death and premature delivery.

Objectives: To evaluate the efficacy of long-term co-trimoxazole treatment in cases of Q fever during pregnancy.

Material and Methods: We evaluated the prognosis of 53 pregnant women who developed Q fever with and without long-term co-trimoxazole treatment defined by the oral taken of trimethoprim and sulfamethoxazole during at least 5 weeks.

Results: In the 37 pregnant women who did not received long-term co-trimoxazole treatment, we observed a 81.1% obstetrical complications rate: 5 (13.5%) spontaneous abortion, 10 (27%) low birth weight, 4 (10.8%) oligoamnios, 10 (27%) intra uterine fetal death and 10 (27%) premature deliveries. Outcome of the pregnancy was found to depend on the trimester in which patients had been infected (p = 0.032) and on the placental infection by Coxiella burnetii (p = 0.013). Long-term co-trimoxazole treatment protected against chronic Q fever (p = 0.001), placental infection (p = 0.038), and obstetrical complication (p = 0.009) especially fetal death (0/16) (p = 0.018).

Conclusions: Our results show that Q fever during pregnancy causes severe obstetrical complications including fetal death. Because of its ability to protect against obstetrical complications and chronic Q fever, long-term treatment by co-trimoxazole should be used to treat women who develop Q fever during pregnancy, specifically when infected during the first trimester.

Session Details

Date: 31/03/2007
Time: 00:00-00:00
Session name: European Society of Clinical Microbiology and Infectious Diseases
Subject:
Location: ICC, Munich, Germany
Presentation type:
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