Chorioamnionitis and neonatal sepsis due to extended‐spectrum beta‐lactamase‐producing Escherichia coli infection: a case report

Chorioamnionitis is an acute inflammation of the membranes and chorion of the placenta typically due to ascending polymicrobial infection in the setting of membrane rupture. It is a common complication of pregnancy associated with significant maternal, perinatal, and long‐term adverse outcomes. We present a case of placental infection leading to preterm delivery, severe neonatal sepsis, maternal wound infection, postnatal readmission, and prolonged hospital stay. This virulent infection was caused by multidrug–resistant extended‐spectrum beta‐lactamase (ESBL)‐producing Escherichia Coli (E. Coli), which represent a major worldwide threat according to the Centre for Disease Control and Prevention (CDC). It was managed with appropriate antibiotic therapy, patient‐centered approach, and multidisciplinary team involvement that led to favourable maternal and neonatal outcome.

[1]  E. Chandraharan,et al.  Cardiotocograph (CTG) changes and maternal and neonatal outcomes in chorioamnionitis and/or funisitis confirmed on histopathology. , 2021, European journal of obstetrics, gynecology, and reproductive biology.

[2]  R. D’Souza,et al.  Determining the optimal antibiotic regimen for chorioamnionitis: A systematic review and meta‐analysis , 2020, Acta obstetricia et gynecologica Scandinavica.

[3]  R. Romero,et al.  Management of Clinical Chorioamnionitis: An Evidence-Based Approach. , 2020, American journal of obstetrics and gynecology.

[4]  Zhenlang Lin,et al.  Multi-Drug Resistant Escherichia coli Causing Early-Onset Neonatal Sepsis – a Single Center Experience from China , 2019, Infection and drug resistance.

[5]  A. Thomson Care of Women Presenting with Suspected Preterm Prelabour Rupture of Membranes from 24+0 Weeks of Gestation , 2019, BJOG : an international journal of obstetrics and gynaecology.

[6]  A. Dall'asta,et al.  Cardiotocographic (CTG) changes observed with clinical and subclinical chorioamnionitis , 2019, European Journal of Obstetrics & Gynecology and Reproductive Biology.

[7]  C. Lal,et al.  Early-Onset Neonatal Sepsis with Extended Spectrum Beta-Lactamase Producing Escherichia Coli in Infants Born to South and South East Asian Immigrants: A Case Series , 2018, American Journal of Perinatology Reports.

[8]  G. Saade,et al.  Evaluation and Management of Women and Newborns With a Maternal Diagnosis of Chorioamnionitis: Summary of a Workshop. , 2016, Obstetrics and gynecology.

[9]  R. Romero,et al.  A point of care test for interleukin-6 in amniotic fluid in preterm prelabor rupture of membranes: a step toward the early treatment of acute intra-amniotic inflammation/infection , 2016, The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians.

[10]  J. Perlow,et al.  A Case of Hematogenous Spread of E. coli causing Clinical Chorioamnionitis , 2015 .

[11]  B. Jacobsson,et al.  Bedside assessment of amniotic fluid interleukin-6 in preterm prelabor rupture of membranes. , 2014, American journal of obstetrics and gynecology.

[12]  H. Villar,et al.  Maternal carriage of extended-spectrum beta-lactamase-producing Escherichia coli isolates in Argentina , 2013, Journal of chemotherapy.

[13]  W. Andrews,et al.  Diagnosis and management of clinical chorioamnionitis. , 2010, Clinics in perinatology.

[14]  E. Newton Chorioamnionitis and Intraamniotic Infection , 1993, Clinical obstetrics and gynecology.

[15]  R. Gibbs,et al.  Progress in pathogenesis and management of clinical intraamniotic infection. , 1991, American journal of obstetrics and gynecology.

[16]  H. Dalton,et al.  Risk factors for intraamniotic infection: a prospective epidemiologic study. , 1989 .