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Federación Mexicana de Ginecología y Obstetricia, A.C.

2018, Number 10

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Ginecol Obstet Mex 2018; 86 (10)

Urinary infection by Acinetobacter baumannii acquired in the community: clinical case of a pregnant patient

Baquero-Marín PJ, Cabarcas-López WF, Carrillo-Betancourt PX, Gaviria-Maya JE, Giraldo-Ospina B, Barrios-Arroyave FA

Language: Spanish
References: 14
Page: 682-686
PDF size: 323.52 Kb.


ABSTRACT

Background: Acinetobacter baumannii is a non-fermentative gram-negative coccobacillus, with a broad spectrum of resistance to antibiotics. There is a relationship between the colonization of the bacteria and complications in the pregnancy, among which are: cord vasculitis, alterations in Wharton gelatin, low birth weight and preterm delivery.
Clinic case: A pregnant woman of 21 weeks of gestation with unquantified fever, abdominal pain in hypogastrium associated with dysuria, bladder tenesmus and one-month-old urinary frequency; urine culture was performed by bladder catheter and processed in an automated MicroScan AutoSCAN-4®, which was positive for Acinetobacter baumannii, with colony counts greater than 100,000 CFU/mL. Due to the clinical picture, contact isolation, control and close maternal-fetal treatment were performed with satisfactory institutional discharge. The patient entered 15 weeks after the previous admission with urinary symptoms, grade III fetal pattern and altered blood biochemistry, whereby she underwent surgery, obtaining a premature birth which was treated with antimicrobial therapy.
Conclusion: Acinetobacter baumannii infections during pregnancy are rare, however is associated with an increase in maternal-fetal morbidity, and delays in the administration are associated with increased maternal-fetal mortality.


REFERENCES

  1. Wong D, et al. Clinical and pathophysiological overview of Acinetobacter infections: a century of challenges. Clinical Microbiology Reviews 2017;30(1): 409-46. doi: 10.1128/ CMR.00058-16

  2. Wenzler E, et al. Anticipating the unpredictable: a review of antimicrobial stewardship and Acinetobacter infections. Infect Dis Ther 2017;6(2):149-172. doi: 10.1007/ s40121-017-0149-y

  3. Thom KA, et al. Factors leading to transmission risk of Acinetobacter baumannii. Critical Care Medicine 2017;45(7):e633- 39. doi: 10.1097/CCM.0000000000002318

  4. Aivazova V, et al. Acinetobacter baumannii infection during pregnancy and puerperium. Archives of Gynecology and Obstetrics 2010;281(1):171-74. doi: 10.1007/s00404- 009-1107-z

  5. Lynch JP, et al. Infections Due to Acinetobacter baumannii in the ICU: Treatment Options. Semin Respir Crit Care Med 2017;38(3):311-25. doi: 10.1055/s-0037-1599225

  6. He M, et al. Perinatal mortality associated with positive postmortem cultures for common oral flora. Infectious Diseasein Obstetrics and Gynecology 2017, Article ID 9027918. https://doi.org/10.1155/2017/9027918

  7. Busey K, et al. Treatment efficacy of Ampicillin/Sulbactam in comparison to alternative beta-lactams for severe Acinetobacter baumannii infections. Infectious Diseases 2016;48(10)775-77. https://doi.org/10.1080/23744235. 2016.1193789

  8. Gu Z, et al. Risk Factors and clinical outcomes for patients with Acinetobacter baumannii bacteremia. Medicine (Baltimore) 2016;95(9):e2943. doi: 10.1097/ MD.0000000000002943

  9. He M, et al. Pregnancy and Perinatal outcomes associated with Acinetobacter baumannii Infection. AJP Rep 2013;3(1)51-6. doi: 10.1055/s-0033-1334460

  10. Jaruratanasirikul S, et al. Population pharmacokinetics and pharmacodynamics modeling to optimize dosage regimens of sulbactam in critically ill patients with severe sepsis caused by Acinetobacter baumannii. Antimicrob Agents Chemother 2016;60(12): 7236-44. doi: 10.1128/AAC.01669-16

  11. McGrath EJ, et al. An outbreak of carbapenem-resistant Acinetobacter baumannii infection in a neonatal intensive care unit: investigation and control. Infect Control Hosp Epidemiol 2011;32(1):34-41. https://doi. org/10.1086/657669

  12. Lob SH, et al. Regional differences and trends in antimicrobial susceptibility of Acinetobacter baumannii. Int J Antimicrob Agents 2016;47(4):317-23. https://doi.org/10.1016/j. ijantimicag.2016.01.015

  13. Lee HY, et al. Risk factors and molecular epidemiology of Acinetobacter baumannii bacteremia in neonates. J Microbiol Immunol Infect 2018;51(3):367-76. https://doi. org/10.1016/j.jmii.2017.07.013

  14. Pinar H, et al. The stillbirth collaborative research network postmortem examination protocol. Am J Perinatol 2011;28(10):793-802. doi: 10.1055/s-0031-1284229




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