Prevalence of antimicrobial-resistant opportunistic pathogens in postpartum women and factors influencing their detection: a review

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Abstract

Antimicrobial resistance in opportunistic microorganisms is a significant challenge to global public health. Despite extensive research, data on the prevalence of resistant opportunistic pathogens in postpartum women is limited and highly heterogeneous.

This article summarizes current data on the prevalence of antimicrobial-resistant opportunistic pathogens colonizing the birth canal in postpartum women and analyzes the factors determining their detection likelihood. The study reviewed 45 papers published between 2000 and 2025. The following keywords were used to search the PubMed and Google Scholar search engines and in the electronic scientific libraries eLibrary.ru and the National Center for Biotechnology Information (NCBI): условно-патогенные микроорганизмы (opportunistic infections), резистентность к антимикробным препаратам (drug resistance, microbial), родильницы (postpartum period), колонизация родовых путей (birth canal colonization), генетические детерминанты резистентности (genetic determinants of resistance). A total of 7179 articles were selected.

A review of publications showed that the most prevalent resistant opportunistic microorganisms detected in postpartum women were Escherichia coli, Staphylococcus aureus, Klebsiella pneumoniae, and Enterococcus spp. Studies reported critical levels of resistance to beta-lactams, including third-generation cephalosporins and carbapenems, with substantial differences in resistance levels across regions. Key risk factors for birth canal colonization with antimicrobial-resistant opportunistic pathogens in postpartum women included invasive obstetric interventions, inappropriate antibiotic therapy, and prolonged hospitalization. Such colonization can lead to clinically significant consequences, including a higher risk of postpartum infectious complications, increased maternal mortality rates, and vertical transmission of antimicrobial-resistant pathogens to neonates.

The review suggests the need for a strategy to control colonization of the birth canal by antimicrobial-resistant opportunistic microorganisms in postpartum women. This strategy should include optimizing screening, antibacterial prophylaxis and treatment, and genomic surveillance for postpartum purulent-septic infections.

About the authors

Svetlana S. Smirnova

Federal Scientific Research Institute of Viral Infections «Virome»; Ural State Medical University

Author for correspondence.
Email: smirnova_ss69@mail.ru
ORCID iD: 0000-0002-9749-4611
SPIN-code: 3127-4296

MD, Dr. Sci. (Medicine), Assistant Professor

Russian Federation, Ekaterinburg; Ekaterinburg

Yulia S. Stagilskaya

Federal Scientific Research Institute of Viral Infections «Virome»; Ural State Medical University

Email: stagilskaya_ys@niivirom.ru
ORCID iD: 0009-0000-9261-5624
SPIN-code: 2923-4892

MD

Russian Federation, Ekaterinburg; Ekaterinburg

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