EP04.12: Successful eradication of group B streptococcus in intra‐amniotic infection in preterm PROM

We report herein a woman who had Streptococcus Group B intra-amniotic infection in which the administration of antibiotics has led to a resolution of intra-amniotic infection and prolong pregnancy. A 35-year-old, gravida 1 at 28 weeks of gestation, presented with preterm PROM. The patient had an elevated white blood cell count and an elevated C-reactive protein level. The patient was counselled and offered a diagnostic amniocentesis. The amniotic fluid was clear yellowish. The amniotic fluid analysis showed a WBC count of 167 cells/mm3 (polymorphonuclear 70%). Amniotic fluid culture and 16S rRNA PCR consistently showed Streptococcus agalactiae (see figure 1). Rectovaginal swab culture also demonstrated Streptococcus agalactiae. Therefore, the patient was diagnosed with intra-amniotic infection. Since she was remotely from term gestation and we performed extensive counselling of benefit and risk of delivery versus antibiotic treatment. The patient opted antibiotic treatment with repeat amniocentesis. We administered triple antibiotics (ceftriaxone, clarithromycin, and metronidazole). During the 2 weeks, the patient had no uterine contraction and no sign of chorioamnionitis. Amniocentesis was repeated (at 29 3/7 weeks of gestation) to assess the resolution of GBS intra-amniotic infection. Amniotic fluid culture and 16S rRNA PCR showed no bacteria. Since GBS intra-amniotic infection was eliminated, we performed expectant management. The main message of this report is that the administration of antibiotics can eliminate GBS intra-amniotic infection and prolong pregnancy in women presenting with preterm PROM. The resolution of GBS in the amniotic fluid was confirmed by both cultivation and molecular microbiologic technique. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.