Mahi BALCI, Birgül KAÇMAZ, Serdar GÜL, Zeynep ÖZCAN DAĞ, Okan ÇALIŞKAN, Özlem TULMAÇ

On haftalık gebede Staphylococcus aureus’un etken olduğu koryoamniyonit

Koryoamniyonite yol açan en önemli nedenenfeksiyondur. Etken bakteriler genellikle genitalmikoplazmalar, anaeroblar, enterik gram-negatifbasiller ve grup B streptokoklardır. NadirenStaphylococcus aureus’da etken olabilmektedir. Buçalışmada S. aureus’un etken olduğu koryoamniyonitvakası sunulmuştur. On haftalık bir gebe, yüksek ateşşikayetiyle hastanemize başvurmuş, fizik muayenesindebatında alt kadran hassasiyeti saptanmıştır. Yapılanultrasonografide fetüs kalp sesi duyulamayan hastayateröpatik abortus planlanmıştır. Koryoamniyonit öntanısıyla tüm kültürleri alındıktan sonra ampirikmeropenem tedavisi başlanmıştır. Operasyon sırasındaalınan amniyon zarı kültüründe ve kan kültürlerindeS. aureus üremiştir. Amniyon zarının histopatolojikincelemesi akut funisit ve akut koryoamniyonitolarak rapor edilmiştir. Tedaviye sefazolin ile devamedilmiş, tedavisi 14 güne tamamlanmıştır. Sonuçolarak koryoamniyonit düşünülen hastalarda nadirenS. aureus’un da etken olabileceği bilinmeli ve ampirikantibiyotik tedavisi buna göre düzenlenmelidir.

Chorioamnionitis caused by Staphylococcus aureus in a ten weeks pregnant patient

Infections are the most important causes of chorioamnionitis. Causative bacteria are usually genital mycobacteria, anaerobes, enteric Gram-negative bacilli and group B streptococci. Staphylococcus aureus can also rarely be the causative agent. In this study a case of chorioamnionitis caused by Staphylococcus aureus was reported. A ten weeks pregnant was admitted to our hospital with fever, physical examination revealed lower quadrant tenderness. Therapeutic abortion was planned for the patient whose fetal heart sounds were not heard by ultrasound. The meropenem treatment was administered to the patient with the pre-diagnosis of chorioamnionitis after obtainined cultures. Then Staphylococcus aureus was growed in the blood cultures and in the cultures of amniotic membranes obtained during operation. The histopathologic examination of the amniotic membranes was reported as acute funisit and acute chorioamnionitis. The therapy was continued with cefazoline and completed in 14 days. As a result Staphylococcus aureus should also be considered as a causative agent in chorioamnionitis cases and the empirical therapy should be administered accordingly.

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