morphine and Bacteremia

To investigate the association of maternal peripartum bacteremia and meconium stained amniotic fluid in early preterm deliveries.. We conducted a single center retrospective study, in a tertiary university affiliated medical center. The study cohort included women with culture proven maternal bacteremia who had a preterm delivery between 24-34 weeks of gestation. The control group composed of women with similar gestational age at delivery without bacteremia. Maternal characteristics were compared between the groups.. During the six-years study period there were 86,590 deliveries in our center. 2625 (3.03 %) women had early preterm deliveries (24-34 weeks), of them 22 (0.84 %) were diagnosed with peripartum bacteremia. The groups were similar with regard to obstetric and demographic characteristics. In the peripartum maternal bacteremia group, we found significantly higher rates of MSAF (6.86 % vs 22.73 %, p = 0.036). Logistic regression of multivariable analysis demonstrated that MSAF is an independent risk factor for maternal bacteremia adjusted for gestational age, intrapartum fever and leukocytosis (Odd Ratio 4.29, 95 % CI 1.26-12.56, p = 0.012) CONCLUSION: Preterm MSAF is an independent risk factor for maternal bacteremia among women with early preterm delivery. More studies are needed to determine the need for broad spectrum antibiotic prophylaxis therapy in preterm deliveries complicated by MSAF.

Topics: Amniotic Fluid; Bacteremia; Female; Gestational Age; Humans; Infant, Newborn; Meconium; Peripartum Period; Pregnancy; Retrospective Studies; Risk Factors

Intestinal atresia type III B (apple peel) and gastroschisis are both congenital malformations who require early surgical correction in neonatal age. Their association is very rare. We present the case of a full term infant with partial apple peel ileal atresia and a small defect of the anterior abdominal wall, complicated by in utero intestinal perforation and subsequent meconial peritonitis. We observed a partial atresia of small intestine, with involvement of terminal ileus savings of jejunum and a large part of the proximal ileum, small anterior abdominal wall defect with herniation of few bowel loops, intestinal malrotation. Paralytic ileus and infections are the main causes of morbidity and mortality at neonatal age. In our case, in spite of the mild phenotype, prognosis has been complicated by the onset of functional bowel obstruction, caused by chemical peritonitis resulting from contact with either amniotic fluid and meconium.

Topics: Abdominal Wall; Bacteremia; Fatal Outcome; Female; Hernia, Abdominal; Humans; Ileum; Infant, Newborn; Intestinal Atresia; Intestinal Perforation; Male; Meconium; Peritonitis; Uterine Perforation

Ochrobactrum anthropi is a non-fermenting gram-negative rod that was identified as a pathogenic microorganism during the past decade. O. anthropi is extensively distributed in the environment, and has been found in hospital and environmental water sources. O. anthropi infection is rare in childhood. We report a case of O. anthropi bacteremia in a preterm infant with a peritoneal lavage catheter and meconium peritonitis.

Topics: Adult; Bacteremia; Catheters, Indwelling; Fatal Outcome; Female; Gram-Negative Bacterial Infections; Humans; Infant, Newborn; Infant, Premature; Infant, Premature, Diseases; Intestinal Perforation; Meconium; Ochrobactrum anthropi; Peritoneal Lavage; Peritonitis; Pregnancy