Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Sep 16, 2022; 10(26): 9323-9331
Published online Sep 16, 2022. doi: 10.12998/wjcc.v10.i26.9323
Cefoperazone-sulbactam and ornidazole for Gardnerella vaginalis bloodstream infection after cesarean section: A case report
Yu Mu, Jing-Jing Li, Xiao Wu, Xin-Fang Zhou, Lian Tang, Qin Zhou
Yu Mu, National Clinical Pharmacist Training Base, The Affiliated Suzhou Hospital, Nanjing Medical University/Suzhou Municipal Hospital, Suzhou 215002, Jiangsu Province, China
Yu Mu, Department of Pharmacy, Xuzhou Maternity and Child Health Hospital/Affiliated Xuzhou Maternity and Child Health Hospital, Xuzhou Medical University, Xuzhou 221000, Jiangsu Province, China
Jing-Jing Li, Lian Tang, Qin Zhou, Department of Pharmacy, The Affiliated Suzhou Hospital, Nanjing Medical University/Suzhou Municipal Hospital, Suzhou 215002, Jiangsu Province, China
Xiao Wu, Xin-Fang Zhou, Department of Obstetrics, The Affiliated Suzhou Hospital, Nanjing Medical University/Suzhou Municipal Hospital, Suzhou 215002, Jiangsu Province, China
Author contributions: Mu Y and Li JJ contributed equally to this work; Mu Y and Li JJ designed the research study; Mu Y, Li JJ, Wu X and Zhou XF collected the data; Mu Y, Li JJ, Lang L and Zhou Q analyzed the data and wrote the manuscript; all authors have read and approved the final manuscript.
Informed consent statement: Written informed consent was obtained from the patient for the publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jing-Jing Li, PharmD, Pharmacist, Department of Pharmacy, The Affiliated Suzhou Hospital, Nanjing Medical University/Suzhou Municipal Hospital, No. 26 Daoqian Street, Gusu District, Suzhou 215002, Jiangsu Province, China. lijingno.2@163.com
Received: March 20, 2022
Peer-review started: March 20, 2022
First decision: May 12, 2022
Revised: May 23, 2022
Accepted: August 6, 2022
Article in press: August 6, 2022
Published online: September 16, 2022
Processing time: 165 Days and 7.6 Hours
Abstract
BACKGROUND

Gardnerella vaginalis (G. vaginalis) is a facultative anaerobic bacteria known to cause bloodstream infections. However, cases are very rare in clinics. There is very limited clinical experience in the treatment of bloodstream infections caused by G. vaginalis. Therefore, there is an urgent need for effective antibacterial drugs to treat patients with bloodstream infections caused by G. vaginalis.

CASE SUMMARY

A woman who underwent a cesarean section presented with a sudden onset of high fever 1-d post-surgery. The blood cultures suggested an infection due to G. vaginalis, and treatment with cefoperazone-sulbactam was started. After 5 d of treatment, there was a decrease in the hemogram; however, the temperature and C-reactive protein levels remained high. Based on clinical experience and a review of literature, the treatment was modified to include ornidazole in combination with cefoperazone-sulbactam. Following a week of treatment, the temperature, hemogram and C-reactive protein levels returned to normal, and blood cultures turned negative, suggesting a therapeutic effect of the combination treatment.

CONCLUSION

This case highlighted the effective use of cefoperazone-sulbactam combined with ornidazole for bloodstream infection caused by G. vaginalis following a cesarean section.

Keywords: Gardnerella vaginalis; Bloodstream infections; Anti-infective; Cefoperazone-sulbactam; Ornidazole; Case report

Core Tip: We analyzed a case of bloodstream infection caused by Gardnerella vaginalis after cesarean section. We believe that our study makes a significant contribution to the literature because it indicates that cefoperazone-sulbactam combined with ornidazole is an effective therapy for bloodstream infection caused by Gardnerella vaginalis after cesarean section.