6th International Congress on Infectious Diseases
National Medical Research Center for Obstetrics, Gynecology and Perinatology, Russia
Title: Case report of postpartum endometritis, complicated by peritonitis and Eggerthella lenta-associated obstetrical sepsis
Biography: Tatiana Priputnevich
Eggerthella lenta-associated sepsis is rarely reported, despite wide possibilities for identification of microorganisms. This case report highlights E. lenta severe endometritis complicated by abdominal sepsis in a young healthy woman. A woman aged 27 at 40 weeks of gestation was admitted to the center in labor. The pregnancy was complicated by bacterial vaginosis in the I trimester, and rotavirus infection which required inpatient care in the II trimester. Due to obstructed labor, caesarean section was performed. Rupture of membranes to delivery interval was 17 hours. Cefazolin was given preoperatively. Further antibacterial therapy with cefazolin was continued for the next 72 hours due to the patient’s history. 72 hours after the delivery the patient exhibited fever (37.5_), leukocytosis, neutrophilia and CRP rise. Microbiological analysis revealed the growth of three species of obligate anaerobes: Bacteroides thetaiotaomicron, Bacteroides uniformis and Eggertella lenta of 5-7 lg CFU/ml. All three isolates appeared sensitive to metronidazole, imipenem, amoxicillin clavulanic acid and resistant to cefotaxime. Eggertella lenta was sensitive to clindamycin, but B. thetaiotaomicron and B. uniformis were resistant to clindamycin; B. thetaiotaomicron was sensitive to moxifloxacin, but B. uniformis and E. lenta were not. E. lenta was sensitive to Vancomycin). MIC Linezolid for E. lenta and B. uniformis was 1 μg/mL and for B. thetaiotaomicron – 2 μg/mL. Th e patient was finally subscribed linezolid together with clindamycin. The patient’s clinical condition rapidly improved the fever and systemic inflammatory response signs resolved. The patient was discharged on the 21st day after delivery in satisfactory condition.