Maternal Sepsis and Antimicrobial Resistance

When a building is burning, water is our best weapon. When an infection is raging in someone’s body, antimicrobial medications (such as antibiotics) are our best weapon. But what if water could no longer put out fire? What if, over time, fire evolved to outsmart water? In such a world, humans would no longer have our best defense against fire – and we would be extremely vulnerable.

Antimicrobial resistance (AMR) happens when germs evolve to avoid the medications designed to treat them. This is an extremely dangerous phenomenon – in fact, the World Health Organization has named antimicrobial resistance among the top threats to global health. As germs learn to outsmart antimicrobial medications, we are losing our best weapon against dangerous infections and sepsis.

Drug-resistant germs, also known as superbugs, are already putting millions of people at risk of developing life-threatening, untreatable infections. At least 2.8 million people in the United States acquire antibiotic-resistant infections each year, and the problem is only growing. Among those disproportionately affected by AMR are pregnant patients.

This Maternal Sepsis Week, we are looking closely at the problem of antimicrobial resistance, including how it relates to sepsis, how it impacts pregnant patients and their babies, and what can be done to curb this threat.

 

AMR and Sepsis: How Are They Connected?

Sepsis and antimicrobial resistance are very closely related. Sepsis Alliance considers these two health crises to be “two sides of one coin.”

Sepsis is always caused by an underlying infection, whether that is a bacterial, viral, parasitic, or fungal infection. Very often, healthcare professionals treat sepsis by aggressively treating the underlying infection with antimicrobial medications. Antimicrobial medications also help to keep everyday infections – such as UTIs, strep throat, or dental infections – from progressing out of control into life-threatening sepsis.

However, as germs become more resistant to antimicrobials, common infections are more likely to progress out of control and develop into sepsis. Sepsis cases become harder – or even impossible – to treat. Without fast-acting medications, sepsis patients are more likely to experience negative outcomes, including amputations and even death.

AMR complicates the treatment of sepsis, and sepsis is one of the most serious complications that can result from drug-resistant infections. These two health crises are closely connected and together, they threaten the very foundations of modern medicine.

 

AMR and Maternal Patients

Pregnant people are disproportionately affected by AMR. That is because pregnant patients naturally experience physiological changes during pregnancy that can make them more at risk of contracting infections, including drug-resistant infections. Pregnant patients often need procedures or surgery, which can place them at higher risk of infection. Pregnant people also experience elevated infection risks due to potential pregnancy complications, such as premature rupture of membranes or gestational diabetes, according to the UK Sepsis Trust.

According to the Centers for Disease Control and Prevention (CDC), sepsis is the second leading cause of pregnancy-related deaths in the United States. A recent analysis of delivery hospitalizations and postpartum readmissions in the U.S. found that 23% of in-hospital deaths were related to sepsis. Annually, an estimated 30,000 women and 40,000 newborn infants die due to severe infections during the period of birth. Many of these sepsis cases and deaths are caused by drug-resistant infections – AMR.

It is important to note that dangerous maternal infections, including AMR infections, are more likely to occur in low- and middle-income countries. Even in the United States, maternal sepsis patients experience inequities: Black women are 3.3 times more likely to die from pregnancy-related causes than white women, while Native American and Native Alaskan women are 2.5 times more likely to die than white women. To learn more about maternal sepsis inequities, click here.

 

What Can We Do?

Tackling the dangerous problem of AMR in pregnant populations will require action from healthcare professionals, governments around the world, and patients. This is a complex problem that will require many different solutions, all working together.

Government officials can help by introducing and passing laws that tackle the threat of AMR. One example is the PASTEUR Act, a bill that helps to protect our antimicrobial medications and encourages the development of brand-new medicines, so that we have more weapons in our arsenal. Another important bill is the SUPER BUGS Act, which will allow the U.S. to partner with foreign countries on the problem of AMR. A global approach is very important, because drug-resistant germs know no national borders. Sepsis Alliance supports both of these bills.

Another important part of the solution is healthcare professional education and awareness. The healthcare professional workforce needs access to education about infection prevention, maternal sepsis and AMR risks, and stewardship practices. This will help them to better treat pregnant patients, identify AMR infections early, and to protect the drugs we already have by using them correctly and sparingly.

Finally, pregnant patients need access to education and awareness as well – to know the risks of AMR, the signs to look out for in themselves, and how they can take simple precautions to be a part of the solution.

 

By raising awareness this Maternal Sepsis Week, we can begin to tackle the dual threats of AMR and sepsis in pregnant populations.

 

To discover more maternal sepsis information and resources, please visit MaternalSepsisWeek.org

To discover Sepsis Alliance’s healthcare professional education offerings, including courses on maternal sepsis and AMR, please visit SepsisInstitute.org.

To learn more about AMR and how you can be a part of the solution, EndSuperbugs.org.

To send a letter to your local newspaper about the maternal sepsis crisis, please visit our Grassroots Action Center.