Klebsiella pneumoniae chorioamnionitis: An underrecognized cause of preterm premature rupture of membranes in the second trimester

Maria Paola Bonasoni, Andrea Palicelli, Giulia Dalla Dea, Giuseppina Comitini, Paola Nardini, Loredana Vizzini, Giuseppe Russello, Marcellino Bardaro, Edoardo Carretto

Research output: Contribution to journalArticlepeer-review

Abstract

Klebsiella pneumoniae is a Gram-negative, rod-shaped bacterium, responsible for hospital and community acquired pneumonia, urinary tract and wound infections, and bloodstream dis-semination. K. pneumoniae infection in pregnancy, leading to acute chorioamnionitis (AC), preterm premature rupture of membranes (PPROM) and early pregnancy loss in the second trimester, has been rarely reported. Herein, we present a case of K. pneumoniae AC that caused intrauterine fetal demise (IUFD) at 19 weeks + 5 days. The 36-year-old mother was admitted at 18 weeks + 1 day of gestation for threatened abortion. IUFD occurred 11 days after. Fetal postmortem showed severe AC and fu-nisitis, neutrophils within alveoli and intestinal lumen, associated with rod-like bacteria. Fetal blood and lung cultures grew K. pneumoniae, β-lactamase-non-producing strain. Antibiogram revealed sen-sitivity for piperacillin/tazobactam. Three days after IUFD, the mother presented with fever (37.8 C) which persisted for one week. Maternal blood and urine cultures were negative. According to fetal microbiological results, available 6 days after IUFD, initial treatment with amoxicillin/clavulanic acid was replaced with piperacillin/tazobactam with full patient recovery. Therefore, in the event of PPROM and IUFD, fetal microbiological investigations should always be performed to isolate the proper etiologic agent and start the correct medical treatment.

Original languageEnglish
Article number96
Pages (from-to)1-10
Number of pages10
JournalMicroorganisms
Volume9
Issue number1
DOIs
Publication statusPublished - Jan 2021

Keywords

  • Chorioamnionitis
  • Klebsiella pneumoniae
  • Preterm premature rupture of membrane

ASJC Scopus subject areas

  • Microbiology
  • Virology
  • Microbiology (medical)

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