Tymon-Rosario Joan, Chuang Meleen
Montefiore Medical Center, Department of Obstetrics & Gynecology and Women's Health, Bronx, NY, USA.
Albert Einstein College of Medicine, Bronx, NY, USA.
Case Rep Obstet Gynecol. 2019 Apr 17;2019:6715974. doi: 10.1155/2019/6715974. eCollection 2019.
Postpartum endometritis is a fairly common postoperative complication occurring in up to 11 percent of all cesarean deliveries. Multidrug-resistant pathogenic organism is increasingly a factor in postoperative source of infection. Postpartum endomyometritis from a multidrug-resistant infection resulting in uterine is one such rare clinical circumstance where there is minimal information in the literature to guide its treatment and management.
A 29-year-old G1P0 who underwent a primary cesarean delivery for a failed induction of labor developed endomyometritis on post-op day one and was treated with multiple broad-spectrum antibiotic regimens. The source of infection was found to be multidrug-resistant with uterine involvement and pelvic abscesses, requiring hysterectomy and drainage of pelvic abscesses. Severe uterine necrosis from this multidrug-resistant infection was noted intraoperatively. After three weeks of antibiotic therapy, she had resolution of her infection.
Multidrug-resistant is a highly pathogenic organism that can cause endomyometritis, persistent bacteremia, and uterine necrosis, which necessitates definitive surgical management with hysterectomy to achieve resolution of the infection.
产后子宫内膜炎是一种相当常见的术后并发症，在所有剖宫产中发生率高达11%。耐多药致病微生物日益成为术后感染源的一个因素。由耐多药感染导致的产后子宫内膜肌炎累及子宫是一种罕见的临床情况，文献中关于其治疗和管理的信息极少。
一名29岁初产妇，因引产失败行首次剖宫产，术后第1天发生子宫内膜肌炎，接受了多种广谱抗生素治疗方案治疗。发现感染源为耐多药，累及子宫并伴有盆腔脓肿，需要行子宫切除术及盆腔脓肿引流术。术中发现这种耐多药感染导致严重子宫坏死。经过三周的抗生素治疗，她的感染得到了控制。
耐多药菌是一种高致病性微生物，可引起子宫内膜肌炎、持续性菌血症和子宫坏死，这需要通过子宫切除术进行确定性手术治疗以控制感染。
