Table 1 Samples for evaluation of Postpartum sepsis in the PP Sepsis Study
Type of Specimen | Methods | Collection protocol/ transport protocol and times | Target pathogens | Purpose |
|---|---|---|---|---|
Blood | Blood count by flow cytometry | Collection in EDTA tube, transport at 2–8 °C, within 4–6 h to laboratory | None | Leukocytosis or leukopenia and thrombocytopenia as parameters of sepsis |
Peripheral blood microscopy for malarial parasites | As above | Plasmodium spp (vivax and falciparum) | Exclusion of malaria as a cause of postpartum fever | |
Culture (aerobic and anaerobic) | Collection in Aerobic and Anaerobic BACTEC blood culture bottles, room temperature, within 4–6 h to laboratory | Bacteria/ fungi | Culture of blood for target pathogens of endometritis | |
Urine | Pyuria by leukocyte esterase Bacteria by nitrite | Collection in boricon-containing wide-mouthed bottles, transport at room temperature, within 4–6 h to laboratory | None | Evaluation of urine as a surrogate specimen for diagnosis of endometritis; correlation with endometrial culture results |
Quantitative culture | As above | Bacteria and yeasts | Â | |
Endometrium | Semiquantitative culture NAAT | Collection in thioglycollate medium, room temperature, within 2–4 h Collection in Universal Transport Medium, transport at 2-8 ° C within 2–4 h to laboratory | Bacteria, yeasts Chlamydia/ Mycoplasma/ Ureaplasma | Reference sample for bacterial pathogens of endometritis |
High vaginal swab | Semiquantitative culture | Collection in Ames transport medium swabs, within 4–6 h, at room temperature | Bacteria, yeasts | Comparison of HVS colonizing flora to evaluate and exclude contamination of vaginal flora from endometrial specimens |