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Escherichia coli is a commensal and opportunistic bacterium widely distributed around the world in different niches including intestinal of humans and animals, and its extraordinary genome plasticity led to the emergence of pathogenic strains causing a wide range of diseases. E. coli is one of the monitored species in maternity hospitals, being the main etiological agent of urogenital infections, endometriosis, puerperal sepsis, and neonatal diseases. This study presents a comprehensive analysis of E. coli isolates obtained from the maternal birth canal of healthy puerperant women 3–4 days after labor. According to whole genome sequencing data, 31 sequence types and six phylogenetic groups characterized the collection containing 53 isolates. The majority of the isolates belonged to the B2 phylogroup. The data also includes phenotypic and genotypic antibiotic resistance profiles, virulence factors, and plasmid replicons. Phenotypic and genotypic antibiotic resistance testing did not demonstrate extensive drug resistance traits except for two multidrug-resistant E. coli isolates. The pathogenic factors revealed in silico were assessed with respect to CRISPR-element patterns. Multiparametric and correlation analyses were conducted to study the interrelation of different pathoadaptability factors, including antimicrobial resistance and virulence genomic determinants carried by the isolates under investigation. The data presented will serve as a valuable addition to further scientific investigations in the field of bacterial pathoadaptability, especially in studying the role of CRISPR/Cas systems in the E. coli genome plasticity and evolution. Full article

Fever is one of the most important signs of infection and can provide useful information for further assessment, diagnosis, and management. Early detection of postnatal fever could reduce severe outcomes, such as maternal mortality due to puerperal sepsis. The purpose of this cross-sectional study was to determine the prevalence of and associated factors of postnatal fever among postnatal women at Kawempe National Referral Hospital. Three hundred postnatal women were recruited. Temperature measurements were conducted and a 29-item questionnaire was completed along with the extraction of health history from the medical records of the participants. The prevalence of maternal fever was 58/300 (19.3%). Multivariable analysis indicated that only four factors—HIV-positive status (AOR = 2.56; 95% CI = 1.02–6.37), labor complications (AOR = 6.53; 95% CI = 2.40–17.71), prolonged labor (AOR = 3.12; 95% CI = 1.11–8.87), and more than 24 h spent in postnatal care (AOR = 5.16; 95% CI = 2.19–12.16)—were found to be significantly associated with postnatal fever. The prevalence of postnatal maternal fever among postnatal women at Kawempe National Referral Hospital was higher than that in other reports in the literature. The factors significantly associated with maternal fever were HIV-positive status, complications during labor, prolonged labor, and more than 24 h spent in postnatal care. Health workers involved in the provision of labor and obstetric services must follow guidelines to assess fever and manage the underlying conditions causing it. Full article

There has been an increasing worldwide incidence of invasive group A streptococcal (GAS) disease in pregnancy and in the puerperal period over the past 30 years. Postpartum Group A streptococci infection, and in particular streptococcal toxic shock syndrome (TSS) and necrotizing fasciitis, can be life threatening and difficult to treat. Despite antibiotics and supportive therapy, and in some cases advanced extensive surgery, mortality associated with invasive group A streptococcal postpartum endometritis, necrotizing fasciitis, and toxic shock syndrome remains high, up to 40% of postpartum septic deaths. It now accounts for more than 75,000 deaths worldwide every year. Postpartum women have a 20-fold increased incidence of GAS disease compared to non-pregnant women. Despite the high incidence, many invasive GAS infections are not diagnosed in a timely manner, resulting in potentially preventable maternal and neonatal deaths. In this paper the specific characteristics of GAS infection in the field of Ob/Gyn are brought to our attention, resulting in guidelines to improve our awareness, early recognition and timely treatment of the disease. New European prevalence data of vaginal GAS colonization are presented, alongside two original case histories. Additionally, aerobic vaginitis is proposed as a supplementary risk factor for invasive GAS diseases. Full article