Routine uterine culture swab during cesarean section and its clinical correlations: A retrospective comparative study.

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  • Additional Information
    • Source:
      Publisher: Elsevier Scientific Publishers Country of Publication: Ireland NLM ID: 0375672 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1872-7654 (Electronic) Linking ISSN: 03012115 NLM ISO Abbreviation: Eur J Obstet Gynecol Reprod Biol Subsets: MEDLINE
    • Publication Information:
      Publication: Limerick : Elsevier Scientific Publishers
      Original Publication: Amsterdam, Excerpta Medica.
    • Subject Terms:
      Cesarean Section/*adverse effects ; Endometritis/*prevention & control ; Fever/*prevention & control ; Puerperal Infection/*prevention & control ; Streptococcal Infections/*prevention & control; Adult ; Anti-Bacterial Agents/therapeutic use ; Elective Surgical Procedures/adverse effects ; Endometritis/drug therapy ; Endometritis/microbiology ; Escherichia coli/isolation & purification ; Female ; Fever/drug therapy ; Fever/microbiology ; Humans ; Microbiological Techniques ; Pregnancy ; Puerperal Infection/drug therapy ; Puerperal Infection/microbiology ; Retrospective Studies ; Risk Factors ; Streptococcal Infections/drug therapy ; Streptococcal Infections/microbiology ; Streptococcus agalactiae/isolation & purification ; Uterus/microbiology ; Uterus/surgery
    • Abstract:
      Objectives: Cesarean sections, particularly non-elective cesareans, are an important risk factor for the development of postpartum endometritis, a leading cause of postpartum febrile morbidity. We evaluated the yield of obtaining routine intrauterine culture during elective and non-elective cesarean sections, in the prevention and management of postpartum endometritis.
      Study Design: A retrospective comparative study investigating the distribution of uterine cultures obtained immediately after fetus and placenta delivery during cesarean sections performed in a single tertiary hospital during 2017. True pathogenic bacteria were included in the study analysis and considered as positive results, while other contaminant bacteria were excluded.
      Results: Positive uterine cultures were identified in 10.7 % (88/821) of cesarean sections, with no significant difference in prevalence between elective and non-elective cesareans. Escherichia coli (E.coli), isolated in 40.9 % of the positive cultures of all women, was the most common organism in non-elective cesareans vs. Group B Streptococcus (GBS) in elective cesareans. Higher rate of positive cultures was found in term vs. preterm cesareans (17.5 % vs 10.5 %, respectively, p-value = 0.04). E.coli was the most frequent pathogen reported in both women with intact membranes or premature rupture of membranes (46.3 % and 47.3 % respectively). Eight women (9.1 %) with positive cultures presented with postpartum fever; all had undergone non-elective cesarean section. In one-third of these cases the empirical antibiotic treatment was adjusted according to the uterine culture results and susceptibility testing results.
      Conclusions: Obtaining routine intrauterine cultures during non-elective cesarean sections might be useful for detecting significant pathogens and tailoring the antibiotic treatment in postpartum endometritis.
      Competing Interests: Declaration of Competing Interest None of the authors report any conflict of interest.
      (Copyright © 2020 Elsevier B.V. All rights reserved.)
    • Contributed Indexing:
      Keywords: Cesarean section; Elective; Intrauterine culture; Pathogens; Postpartum endometritis; non elective
    • Accession Number:
      0 (Anti-Bacterial Agents)
    • Publication Date:
      Date Created: 20200430 Date Completed: 20210305 Latest Revision: 20210305
    • Publication Date:
      20240829
    • Accession Number:
      10.1016/j.ejogrb.2020.04.011
    • Accession Number:
      32348949