title: The primary microbial pathogens associated with premature rupture of the membranes in China: a systematic review.
abstract: To describe the spectrum of pathogens isolated from Chinese women experiencing premature rupture of the membranes (PROM) and those of their neonates, in order to provide effective management of PROM. We searched Ovid Medline, Chinese Biomedical Literature Database, China National Knowledge Infrastructure, and VIP Database for Chinese Technical Periodicals up to April 2012. The quality of studies was assessed utilizing the Strengthening the Reporting of Observational Studies in Epidemiology Statement. Among the included 36 studies, 11 (30.55%) were deemed to be at Level A, 12 (33.33%) at Level B, three (8.33%) at Level C, and 10 (27.78%) at Level D. Staphylococcus and Escherichia coli were the two primary microorganisms isolated from women with PROM and their infants. Subgroup analysis showed the distribution of microorganisms from the six regions of China varied. Staphylococcus bacteria were resistant to penicillins, except oxacillin, but more sensitive to first- and second-generation cephalosporins. Escherichia were sensitive to first- and second-generation cephalosporins and were more sensitive to aztreonam than cephalosporins. The main pathogens derived from women with PROM and their newborns were Staphylococcus and E. coli, which differs from the pathogens in Western countries. Hence, one might infer that the pathogens involved in PROM should be defined in each region to maximize antibiotic effectiveness. In addition, randomized controlled studies are needed to compare prophylactic use of antibiotics versus use of antibiotics after a positive culture for newborn infants with a history of PROM.
authors.affiliation: Department of Pharmacy, West China Second University Hospital, Sichuan University, Chengdu, China; Evidence-Based Pharmacy Centre, West China Second University Hospital, Sichuan University, Chengdu, China; Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China.
authors.forename: Li-nan
authors.initials: LN
authors.lastname: Zeng
authors.affiliation: Department of Pharmacy, West China Second University Hospital, Sichuan University, Chengdu, China; Evidence-Based Pharmacy Centre, West China Second University Hospital, Sichuan University, Chengdu, China; Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China. Electronic address: zhlingli@sina.com.
authors.forename: Ling-li
authors.initials: LL
authors.lastname: Zhang
authors.affiliation: Evidence-Based Pharmacy Centre, West China Second University Hospital, Sichuan University, Chengdu, China; Department of Neonatology, West China Second University Hospital, Sichuan University, Chengdu, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Shi
authors.affiliation: West China School of Pharmacy, Sichuan University, Chengdu, China.
authors.forename: Li-ling
authors.initials: LL
authors.lastname: Gu
authors.affiliation: Department of Pharmaceutical Services, The Nebraska Medical Centre, Omaha, NE, USA.
authors.forename: Wendie
authors.initials: W
authors.lastname: Grogan
authors.affiliation: Department of Pharmaceutical Services, The Nebraska Medical Centre, Omaha, NE, USA.
authors.forename: Mary M
authors.initials: MM
authors.lastname: Gargano
authors.affiliation: West China School of Pharmacy, Sichuan University, Chengdu, China.
authors.forename: Chen
authors.initials: C
authors.lastname: Chen
mesh_terms: D002681:China; D004926:Escherichia coli / Q000302:isolation & purification*; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000382:microbiology*; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy; D013210:Staphylococcus / Q000302:isolation & purification*
keywords: China; pathogens; premature rupture of the membranes; systematic review