Colaneri Marta, Biscarini Simona, Tiranini Lara, Pesare Rebecca, Valsecchi Pietro, Seminari Elena, Spinillo Arsenio, Bandera Alessandra, Ferrazzi Enrico Mario, Gori Andrea, Carenzi Laura, Pusterla Luigi, D'Amico Federico, Raimondi Alessandro, Puoti Massimo, Vallicella Elisa, Grisolia Gianpaolo, Casari Salvatore, Zavatta Alice, Cetin Irene, Bonetti Alice, Corbella Marta, Baldanti Fausto, Cambieri Patrizia, Brambilla Paola, Klersy Catherine, Torriani Camilla, Monti Maria Cristina, Bruno Raffaele
Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy.
Centre for Multidisciplinary Research in Health Science, University of Milan, Milano, Italy.
Open Forum Infect Dis. 2025 Jun 16;12(7):ofaf337. doi: 10.1093/ofid/ofaf337. eCollection 2025 Jul.
In 2018, Lombardy's Fight Against Sepsis in Obstetrics group developed a regional sepsis management bundle for obstetric patients. This study aimed to evaluate the impact of this bundle on maternal and neonatal clinical outcomes and on process measures.
This multicenter, observational, retrospective study included data from pregnant and puerperal adult patients diagnosed with sepsis according to the Surviving Sepsis Campaign guidelines in 2 periods: May 2015 to May 2018 (prebundle) and July 2018 to January 2023 (postbundle).
Eighty women were included: 24 (30.0%) in the prebundle period and 56 (70.0%) in the postbundle period. The primary source of infection was urinary (40.0%), with being the most common pathogen isolated from blood cultures. Regarding clinical outcomes, no deaths occurred in pre- and postbundle periods. For mothers, there was no significant difference in median length of stay between the groups, while neonatal intensive care unit admissions of neonates significantly decreased from 85.7% to 31.3% ( = .013). Regarding process measures, the only significant increase occurred in infectious disease specialist consultations in the postbundle period (75.0%) as compared with the prebundle period (50.0%, = .029).
The implementation of a regional maternal sepsis management bundle did not significantly alter maternal outcomes but was associated with a reduction in neonatal intensive care unit admissions, although what role bundle implementation had in this change remains uncertain. More infectious disease consultations postbundle highlight the potential role of the bundle increasing sepsis awareness among physicians dealing with these patients.
2018年，伦巴第地区产科败血症防治小组为产科患者制定了一项区域性败血症管理综合措施。本研究旨在评估该综合措施对孕产妇和新生儿临床结局以及流程指标的影响。
这项多中心、观察性、回顾性研究纳入了根据《拯救脓毒症运动》指南在两个时间段诊断为脓毒症的妊娠和产后成年患者的数据：2015年5月至2018年5月（综合措施实施前）和2018年7月至2023年1月（综合措施实施后）。
共纳入80名女性：综合措施实施前期24名（30.0%），综合措施实施后期56名（70.0%）。主要感染源为泌尿系统（40.0%）， 是血培养中分离出的最常见病原体。关于临床结局，综合措施实施前和实施后均未发生死亡。对于母亲而言，两组之间的中位住院时间无显著差异，而新生儿重症监护病房的新生儿入院率从85.7%显著降至31.3%（P = ･013）。关于流程指标，与综合措施实施前期（50.0%，P = ･029）相比，综合措施实施后期唯一显著增加的是传染病专家会诊（75.0%）。
实施区域性孕产妇败血症管理综合措施并未显著改变孕产妇结局，但与新生儿重症监护病房入院率降低有关，尽管综合措施实施在这一变化中所起的作用仍不确定。综合措施实施后更多的传染病会诊突出了该综合措施在提高处理这些患者的医生对败血症认识方面的潜在作用。
