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Obstetrics and Gynegology2022№4
The current state of the...

The current state of the problem and a clinical observation of therapy for obstetric sepsis caused by ESKAPE pathogens

DOI
https://dx.doi.org/10.18565/aig.2022.4.164-175

Belov A.V., Pyregov A.V., Troshin P.V., Priputnevich T.V., Kosinov F.A., Rogachevsky O.V., Shabanova N.E., Chuprynin V.D., Nikolaeva A.V.

Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia, Moscow, Russia
Background: According to the World Health Organization (WHO), sepsis is one of the three main causes of maternal death worldwide. The typical causative agents of sepsis in obstetrics remain sensitive to most antibacterial drugs. But, despite this, there is a steady increase in antibiotic-resistant strains of microorganisms in the population and a rise in severe cases of obstetric sepsis refractory to treatment.
Case report: The authors describe a case in which, due to routing errors in the postpartum period, a female patient was infected with multidrug-resistant (MDR) microorganisms belonging to the ESKAPE pathogen group and they also provide an overview of the current procedures for overcoming antibacterial resistance.
Conclusion: The systematic, multidisciplinary approach to treating sepsis in obstetrics, the widespread introduction of efferent procedures to prevent and treat multiple organ dysfunction, the close adherence to the rules of asepsis and antisepsis in managing these patients, the routing obstetric patients to specialized level III obstetric hospitals will decline the number of cases of near-miss and maternal mortality from obstetric sepsis.

Keywords

obstetric sepsis
ESKAPE pathogens
antibacterial therapy
bacteriophages
Full text (in Russian)

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Received 31.01.2022

Accepted 24.03.2022

About the Authors

Alexander V. Belov, PhD, Associate Professor at the Department of Anesthesiology and Resuscitation, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Healthcare of Russian Federation, +7(495)438-77-77, a_belov@oparina4.ru, 117997, Russia, Moscow, Ac. Oparin str., 4.
Aleksey V. Pyregov, Dr. Med. Sci., Associate Professor, Director of the Institute of Anesthesiology-Resuscitation and Transfusiology, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Healthcare of Russian Federation, +7(495)438-77-77, a_pyregov@oparina4.ru,
117997, Russia, Moscow, Ac. Oparin str., 4.
Pavel V. Troshin, Assistant of the Department of Anesthesiology and Resuscitation, Academician V.I.Kulakov National Medical Research Center for Obstetrics, Gynecology
and Perinatology, Ministry of Healthcare of Russian Federation, +7(495)438-77-77, p_troshin@oparina4.ru, 117997, Russia, Moscow, Ac. Oparin str., 4.
Tatyana V. Priputnevich, Dr. Med. Sci., Director of the Institute of Microbiology, Antimicrobial Therapy and Epidemiology of Clinical Epidemiology, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Healthcare of Russian Federation,
+7(495)438-25-10, t_priputnevich@oparina4.ru, 117997, Russia, Moscow, Ac. Oparin str., 4.
Fedor A. Kosinov, Researcher, Institute of Anesthesiology-Resuscitation and Transfusiology, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Healthcare of Russian Federation, +7(495)438-77-77, f_kosinov@oparina4.ru, 117997, Russia, Moscow, Ac. Oparin str., 4.
Oleg V. Rogachevsky, Dr. Med. Sci., Professor, Head of the Department of Extracorporeal Methods of Treatment and Detoxification, Professor at the Department of Anesthesiology and Resuscitation, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology,
Ministry of Healthcare of Russian Federation, +7(495)438-71-35, о_rogachevskiy@oparina4.ru4, https://orcid.org/0000-0002-4332-430X,
117997, Russia, Moscow, Ac. Oparin str., 4.
Natalia E. Shabanova, PhD, Researcher in the Unit of Clinical Pharmacology, the Institute of Microbiology, Antimicrobial Therapy and Epidemiology of Clinical Epidemiology, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Healthcare of Russian Federation,
+7(985)097-58-27, n_shabanova@oparina4.ru, 117997, Russia, Moscow, Ac. Oparin str., 4.
Vladimir D. Chuprynin, Ph.D., Head of the Surgery Department, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Healthcare of Russian Federation, +7(495)438-35-75, v_chuprynin@oparina4.ru, 117997, Russia, Moscow, Ac. Oparin str., 4.
Anastasia V. Nikolaeva, PhD, Chief Physician, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology,
Ministry of Healthcare of Russian Federation, a_nikolaeva@oparina4.ru, 117997, Russia, Moscow, Ac. Oparin str., 4.

Authors' contributions: Belov A.V. – idea of the article, structure and body text, search for sources, analysis of the main stages of treatment and diagnostic measures; Pyregov A.V. – idea of the article, editing the body text, making key changes and references; Priputnevich T.V. – analysis of the female patient’ microbiological profile, editing the article part on antibiotic therapy and the female patient’s microflora; Troshin P.V., Kosinov F.A. – work with primary medical documentation, analysis of the clinical case; Rogachevsky O.V. – analysis and editing the part on efferent treatments; Shabanova N.E. – collection and analysis of primary data on analysis of the female patient’s microbiological profile of and antibacterial therapy; Chuprynin V.D. – analysis of procedures for surgical treatment stage, editing this part of the article; Nikolaeva A.V. – idea of the article, general text editing.
Conflicts of interest: The authors declare that there are no conflicts of interest.
Funding: The article has been prepared without sponsorship.
For citation: Belov A.V., Pyregov A.V., Troshin P.V., Priputnevich T.V., Kosinov F.A., Rogachevsky O.V., Shabanova N.E., Chuprynin V.D., Nikolaeva A.V. The current state of the problem and a clinical observation of therapy for obstetric sepsis caused by ESKAPE pathogens.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2022; 4: 164-175 (in Russian)
https://dx.doi.org/10.18565/aig.2022.4.164-175

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