P-998. A multi-center observational study in Northern Italy to evaluate the impact of Sepsis bundle in Obstetric Settings: the SOS study

Abstract Background Maternal sepsis presents challenges in early detection and treatment. A pregnancy-specific sepsis scoring system (MEOWS) and management bundles for pregnant septic patients were recently introduced, but there is a lack of data on their effectiveness. Our study aims to assess the impact of implementing a Lombardy sepsis bundle for septic pregnant and puerperal patients.Table 1:Demographic and clinical data of the patients included Methods The SOS, a retrospective multicenter study across 7 Lombardy Hospitals, focuses on adult pregnant and puerperal women diagnosed with sepsis according to SCC [1]. Medical records from 2 periods were analyzed: pre-bundle implementation (May 2015 - May 2018) and post-bundle implementation (Jan 2019 - Jan 2022). The primary outcome was to describe clinical and microbiological data, while the secondary outcome was to evaluate the impact of the Sepsis bundle on the length of stay (LOS), the timing of antibiotic treatment, and the rate of positive blood cultures (BCs). Results Eighty patients (24 in the pre-bundle and 56 in the post bundle period) were found (Table 1). Overall, median age was 31 years, they had few underlying comorbidities and mostly were pregnant (rather than puerperal) in the moment of sepsis occurrence (Table 2). More than half of the post-bundle patients had a high MEOWS score (62%) and an mSOFA score of more than 1 (70%) (tablee 2). Microbiological data are detailed in Table 3, while outcome data in Table 4. No significant differences were found in the rate of positive BCs (p=1) between the 2 periods. Similarly, the rate of antibiotic treatment started before BCs collection, and the LOS did not significantly differ (p=0.40). However, in the post-bundle period there were both a marked increase in infectious disease (ID) consultations (p=0.003), and a reduction of neonatal Intensive Care Unit admission (p=0.013). Conclusion While the bundle did not significantly improve maternal outcomes, it led to an increased number of ID consultations, providing a more comprehensive understanding of sepsis severity, and a consequent reduction of neonatal severity conditions. Disclosures All Authors: No reported disclosures