Purulent-septic infections in puerperas. Part 2. Clinical and pathogenetic characteristics of nosological forms, etiology and antibiotic resistance (literature review)

Abstract

Despite the improvement of the obstetric care system, purulent-septic infections (PSI) of puerperas and the associated maternal mortality do not lose relevance at the present time. This study analyzed publications on the following information resources: eLibrary, Google Scholar, PubMed, NCBI on the clinical and pathogenetic characteristics of postpartum GSI (sepsis, peritonitis, endometritis, mastitis, and surgical site infections (SSI)) and their leading pathogens. It should be said that the clinical picture of PSI in the postpartum period does not always correspond to the degree of activity of the infectious process, which leads to late diagnosis of the local focus of infection and, in the future, to its generalization. A modern feature of the PSI of puerperas is their polyetiology, with a predominance of opportunistic microorganisms, the role of individual representatives of which is far from unambiguous and requires discussion. In recent years, the etiological and epidemiological significance of gram-negative microorganisms of the Enterobacteriaceae family, including those with multidrug resistance, has been increasing. Thus, despite a sufficient amount of information on the etiology and clinical and pathogenetic features of PSI in the postpartum period, an interdisciplinary approach is needed to study this problem with the participation of different specialists: obstetricians-gynecologists, microbiologists, clinical pharmacologists and epidemiologists.