Cefoperazone-sulbactam and ornidazole for Gardnerella vaginalis bloodstream infection after cesarean section: A case report

Table 1 Clinical information and anti-infective treatment

Date	Basic information about the patient	Antimicrobial treatment
November 19, 2021 (C-section day)
Postoperative D1	The patient had a sudden fever in the afternoon and reported the highest temperature of 39.7 ℃ at 10:00 pm. Blood examinations indicated WBC was 15.97 × 109/L, NEUT was 84.7% and CRP was 93.96 mg/L	Cefoperazone-sulbactam (2:1) 3 g iv q12h
Postoperative D2	The temperature was 38.6 ℃ at 2:00 am and 38 ℃ at 6:00 pm. The abdominal incision of the patient was clean and dry, and the patient’s intestinal function had been restored	No changes in the treatment regimen
Postoperative D3	The temperature was normal and routine blood examination indicated that WBC was 10.38 × 109/L, NEUT was 71.3%, and CRP was 93.96 mg/L. Blood culture (first time) results suggested the possibility of gram-negative bacterial growth	Cefoperazone-sulbactam (2:1) 3 g iv q8h
Postoperative D4	A temperature of 37.6 ℃ was reported at 2:00 pm and was normal for the rest of the day	No changes in the treatment regimen
Postoperative D6	The temperature was 37.6 ℃ at 2:00 pm. Blood culture (first time) results suggested the growth of Gardnerella vaginalis (gram-negative bacteria) in anaerobic bottles (left and right). Blood examination indicated that WBC was 8.11 × 109/L, NEUT was 63.9%, and CRP was 77.88 mg/L	Cefoperazone-sulbactam (2:1) 3g iv q8h combined with ornidazole 0.5 g q12h
Postoperative D9	Temperature occasionally reached 37.7 ℃ and was normal for the rest of the day	No changes in the treatment regimen
Postoperative D10	The results of the blood culture (second time) showed no further bacterial growth	No changes in the treatment regimen
Postoperative D12	The temperature was normal, no discomfort, the uterus was well restored, and the patient’s blood tests were normal	No changes in the treatment regimen
Postoperative D14 (discharge day)	The results of the blood culture (third time) showed that there was no bacterial growth, and the patient could be discharged	Antimicrobial treatment was stopped

WBC: White blood cell; NEUT: Neutrophil count; CRP: C-reactive protein; C-section: Cesarean section; D: Day.