Maternal and neonatal bloodstream infections: data from the Finnish Hospital Infection Program, 19992006
Abstract number: P1092
Sarvikivi E., Lyytikäinen O.
Objectives: Maternal microbial flora may be a source for both maternal and newborn peripartum infection. The aim of this study was to evaluate the epidemiologic features and distribution of the causative pathogens of healthcare-associated bloodstream infections (BSIs) in women who were admitted for obstetric care and in neonates in Finnish hospitals during 19992006.
Methods: A prospective laboratory-based surveillance was performed in 9 Finnish acute care hospitals that participated in the Finnish Hospital Infection Program, including three tertiary care centres. Women in labour and infants with ages not more than 28 days were included. Infection-control nurses in each hospital regularly reviewed the laboratory database for positive blood culture results. Clinical information and microbiological data were recorded on a standardised case-record form. CDC definitions for nosocomial BSIs were utilised, both primary and secondary BSIs were included. We focused on `early-onset' neonatal BSIs, referring to an infection with a positive blood-culture during the first 6 days of life.
Results: The study included 175 445 deliveries, of which 30 178 (17%) caesarean sections, and 177 987 live births. We identified 118 maternal peripartum BSIs (rate, 0.7 BSIs/1000 deliveries; range by year, 0.31.5/1000 deliveries), of which 67 (57%) occurred after a caesarean section, and 766 neonatal BSIs (rate, 4.4 BSIs/1000 live births), 288 (38%) of which were early-onset BSIs (rate, 1.6 BSIs/1000 live births; range by year, 1.12.4/1000 live births). The main causative pathogen of both maternal and neonatal early-onset BSIs was Streptococcus agalactiae (GBS) (Table). Of the infants with early-onset BSIs, 116 (40%) received intensive care and 16 (6%) died within a week after the positive blood culture; 7 (44%) of those had GBS disease. One of the mothers received intensive care, none of them died.
Conclusions: Maternal peripartum BSIs were rare and no fatal cases were detected. Neonatal early-onset infections were more common and led often to need of intensive care and even to death. Peripartum infections due to GBS, which was the most common pathogen, may be reduced by national prevention guidelines. Such guidelines were released in 2006 in Finland; future surveillance will show the impact of these guidelines.
Table: Distribution of causative pathogens in maternal and neonatal healthcare-associated bloodstream infections (BSIs) in Finland during 19992006
|Session name:||18th European Congress of Clinical Microbiology and Infectious Diseases|
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