Pathogens identified per specimen type.

IntroductionGreater than half of in-hospital maternal deaths are caused by sepsis, a condition that occurs when infection exceeds local tissue containment and results in organ dysfunction. Determining the source of infection can be challenging. Microbiological cultures of the uterine cavity are often difficult to obtain, so antimicrobial susceptibility results may not be available to guide treatment. The aim of this retrospective study was to assess the potential clinical value of microbiology samples used in the maternal “septic screen” of patients in an Irish maternity hospital.MethodsA review was completed of all maternal “septic screen” (i.e., high vaginal swabs, placenta swabs, blood cultures, throat swabs and urine samples) microbiology results from July 2016 to December 2021.ResultsIn the relevant period, 845 patients were subject to a “septic screen”, of whom 430 also had a placental swab collected. These 430 patients comprise our study population. 2% of blood cultures yielded potential pathogens, compared with 37%, 33%, 9% and 7% respectively for placental swabs, high vaginal swabs, throat swabs and urine specimens. 95% of blood cultures were sterile, compared with 52%, 0%, 0% and 53% respectively for placental swabs, high vaginal swabs, throat swabs and urine specimens.ConclusionOf the five microbiological specimen types examined, placental swabs yielded the highest number of potential pathogens. Our results suggest that placental swabs are useful specimens for detecting potential pathogens from the uterine cavity, the most common source of perinatal infections.引言：超过半数的住院孕产妇死亡由脓毒症（sepsis）引发，脓毒症是指感染突破局部组织局限并导致器官功能障碍的病症。明确感染源往往颇具挑战。宫腔微生物培养通常难以获取，因此无法获得抗菌药物敏感性结果以指导治疗。本回顾性研究旨在评估爱尔兰某妇产医院孕产妇脓毒症筛查（septic screen）所使用的微生物样本的潜在临床价值。 方法：本研究回顾了2016年7月至2021年12月期间所有孕产妇脓毒症筛查的微生物学检测结果，所涉标本包括高阴道拭子（high vaginal swabs）、胎盘拭子（placental swabs）、血培养（blood cultures）、咽拭子（throat swabs）及尿液样本（urine samples）。 结果：在上述研究时间段内，共有845名患者接受了脓毒症筛查，其中430名患者同时采集了胎盘拭子。本研究的研究人群即为这430名患者。血培养的潜在病原体检出率为2%，而胎盘拭子、高阴道拭子、咽拭子及尿液标本的检出率分别为37%、33%、9%和7%。血培养的无菌率为95%，胎盘拭子、高阴道拭子、咽拭子及尿液标本的无菌率分别为52%、0%、0%和53%。 结论：在本次研究检测的5种微生物标本类型中，胎盘拭子的潜在病原体检出数量最多。研究结果表明，胎盘拭子是检测宫腔（围产期感染最常见的来源）潜在病原体的有效标本。