The role of cervical cultures to guide perioperative antibiotics in cervical cerclage - a retrospective analysis of 65 consecutive cases.

Autor:	Moisidis-Tesch, Christina M., Ginsberg, Norman A., Uleer, Christoph, Möbus, Volker J.
Předmět:	PERIOPERATIVE care ANTIBIOTICS CERVICAL cerclage PREMATURE rupture of fetal membranes ANTIBIOTIC prophylaxis CERVIX uteri surgery PREVENTION of communicable diseases PREVENTION of pregnancy complications COMMUNICABLE disease epidemiology CERVIX uteri COMMUNICABLE diseases FETAL diseases GRAM-negative bacteria GRAM-negative bacterial diseases GRAM-positive bacteria LONGITUDINAL method MICROBIAL sensitivity tests PREGNANCY complications PREOPERATIVE care GRAM-positive bacterial infections TREATMENT effectiveness DISEASE incidence RETROSPECTIVE studies PREVENTION
Zdroj:	Journal of Maternal-Fetal & Neonatal Medicine; Nov2016, Vol. 29 Issue 22, p3629-3633, 5p
Abstrakt:	Objective: The objective of this study is to examine results of bacterial cultures of the cervix prior to cerclage placement and how these may be used to guide prophylactic antibiotics.Methods: All patients undergoing cerclage between 2000 and 2003 in a single, large community hospital were evaluated for indication for cerclage, signs and symptoms on presentation, transvaginal ultrasound cervical length findings, type of cerclage placed, type of anesthesia used, cervical culture taken, tocolytics given, gestational age at delivery, and complications surrounding delivery.Results: Sixty-five cerclages were performed between 2000 and 2003, 13 (20%) prophylactic, 47 (72%) therapeutic, and five (8%) emergent. Cervical cultures were obtained in 85% of patients, of which 40% were negative resulting in no antibiotics given. In the remaining 45%, one or more pathogens were isolated and antibiotics were given according to sensitivities reported. Fifty-five of 65 patients (84%) delivered after 32 weeks gestation and a latency > 60 d was seen in 84%. The incidence of chorioamnionitis and PPROM was low.Conclusion: Bacterial cultures of the cervix prior to cerclage show variable colonization and antibiotic sensitivities and, there is no single antibiotic, chosen empirically, that will cover all pathogens. [ABSTRACT FROM AUTHOR]
Databáze:	Complementary Index
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