Chew Ka Lip, Tan Ker Xin, Teo Jeanette
Department of Laboratory Medicine, National University Hospital, Singapore.
IDCases. 2025 Apr 11;40:e02225. doi: 10.1016/j.idcr.2025.e02225. eCollection 2025.
This case report highlights a infection associated with chorioamnionitis following preterm premature rupture of membranes (PPROM) in a 43-year-old pregnant woman at 30 weeks gestation. The patient presented with a mild fever and increased white cell count, leading to the diagnosis of chorioamnionitis. Empiric antibiotic treatment with ampicillin and gentamicin was initiated, later switched to ceftriaxone. was identified through routine placental cultures on CDC Anaerobic Blood Agar, and confirmed by whole-genome sequencing (WGS) using the Illumina HiSeq platform. The WGS revealed no resistance mutations to macrolides, quinolones, or tetracyclines, and predicted susceptibility to these antimicrobials. The isolate exhibited a high number of SNP differences (5471-8074) compared to publicly available genomes. No specific anti- treatment was administered, and both mother and newborn had favourable outcomes. This case underscores the importance of considering infections in pregnancy complications and the need for specialized testing, as routine cultures may fail to detect these organisms. WGS offers a comprehensive approach to pathogen identification and drug resistance profiling, though the clinical impact of targeted antimicrobial therapy for infections in such cases remains uncertain.
本病例报告重点介绍了一名30周妊娠的43岁孕妇在胎膜早破(PPROM)后发生的与绒毛膜羊膜炎相关的感染。患者出现低热和白细胞计数升高,导致绒毛膜羊膜炎的诊断。开始使用氨苄西林和庆大霉素进行经验性抗生素治疗,后来改为头孢曲松。通过在疾病控制与预防中心(CDC)厌氧血琼脂上进行常规胎盘培养鉴定出[具体病原体未给出],并使用Illumina HiSeq平台通过全基因组测序(WGS)进行了确认。WGS显示对大环内酯类、喹诺酮类或四环素类没有耐药突变,并预测对这些抗菌药物敏感。与公开可用的[具体病原体未给出]基因组相比,该分离株表现出大量单核苷酸多态性差异(5471 - 8074)。未给予特定的抗[具体病原体未给出]治疗,母亲和新生儿均获得良好结局。该病例强调了在妊娠并发症中考虑[具体病原体未给出]感染的重要性以及进行专门检测的必要性,因为常规培养可能无法检测到这些病原体。WGS为病原体鉴定和耐药性分析提供了一种全面的方法,尽管在这种情况下针对[具体病原体未给出]感染的靶向抗菌治疗的临床影响仍不确定。