Prognosis and effectiveness of antibacterial treatment of endometritis after cesarian section with isolating drug-resistent ESKAPE pathohens

Abstract

Purpose. The purpose of this study was to determine the frequency of isolation of drug-resistant ESKAPE pathogens isolation in endometritis after cesarean section; to assess the prognosis of the disease and the effectiveness of initial empirical antimicrobial therapy for isolating multiresistant pathogens. Methods. A retrospective analysis of all the cases of endometritis after cesarean section in St. Petersburg was performed. The study period: September 2008 September 2019. Results. 68 (26.7%) out of 255 cases of endometritis after cesarean section were caused by pathogens of the rESKAPE group. In puerperas with endometritis caused by rESKAPE pathogens, the following are more often observed: clinical failures in prescribing initial empirical antimicrobial therapy compared with endometritis of another etiology (p = 0.0012); severe course of infectious process with the risk of its generalization and hysterectomy (p 0.05). Conclusions. Endometritis after abdominal delivery caused by rESKAPE pathogens is associated with an unfavorable prognosis of the disease and a high risk of ineffective antimicrobial therapy.