Abstrakt
A 31-y-old woman with preterm dichorionic diamniotic twins was admitted due to the rupture of membranes. Tocolytics, antenatal corticosteroids and antibiotics were administered in view of chorioamnionitis (patient history, elevated C-reactive protein).
Inflammatory markers escalated despite treatment and failed tocolysis led to cesarean section at 24 + 5 wk gestational age. Both infants suffered from severe respiratory distress syndrome and required prolonged ventilatory support.
The infants were started on Penicillin and Gentamicin, however, no serious signs of sepsis were observed and the blood sample at admission revealed no significant elevation of inflammatory markers. Nevertheless, blood cultures were positive for Lactobacillus spp.
The infants were treated successfully with antibiotics for seven days and post-treatment blood cultures were negative. The infants' outcome was favourable without any serious adverse events.
In our case, the twins' blood cultures at admission were positive for Lactobacillus spp. Interestingly, the inflammatory response in infants was minimal including the twin A, where histological chorioamnionitis was confirmed.
The infection transmission remains unclear as we were unable to cultivate Lactobacillus spp. from any other site (neonatal, placental and cervicovaginal swabs). However, the contamination was considered unlikely as blood cultures were obtained by two skilled neonatologists in a tertiary center.