{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T22:13:44Z","timestamp":1781648024131,"version":"3.54.5"},"reference-count":11,"publisher":"Springer Science and Business Media LLC","issue":"2","license":[{"start":{"date-parts":[[2019,9,23]],"date-time":"2019-09-23T00:00:00Z","timestamp":1569196800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2019,9,23]],"date-time":"2019-09-23T00:00:00Z","timestamp":1569196800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Infection"],"published-print":{"date-parts":[[2020,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n<jats:sec>\n<jats:title>Objectives<\/jats:title>\n<jats:p>There is increasing evidence indicating an association between invasive non-typeable<jats:italic> Haemophilus influenzae<\/jats:italic> (NTHi) infection in pregnancy and early pregnancy loss. As the diagnosis relies on microbiological investigation of post-mortem placental and foetal samples, a significant proportion of NTHi-related pregnancy loss remains unrecognised. To better characterise NTHi in septic abortion, we report NTHi cases associated with early pregnancy loss.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>We reviewed all post-mortems at &lt;24 weeks gestation with histologically proven acute chorioamnionitis on placental histology and enrolled cases with at least one matched foetal and placental sample culture positive for NTHi. The study was approved by the NHS Lothian Caldicott Guardian.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>In our cohort, invasive NTHi has accounted for 20% of infections associated with early pregnancy loss prior to 24 weeks gestation. All patients were young and healthy pregnant women at &lt; 20 weeks' gestation who presented with abdominal pain, PV bleed \/discharge and were septic at the time of presentation. One patient with previous history of miscarriage who presented with cervical incompetence had more severe pathology suggestive of early intrauterine pneumonia.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Conclusion<\/jats:title>\n<jats:p>The burden of invasive NTHi disease in early pregnancy loss is likely to be much larger than currently recognised. NTHi should be considered in pregnant women presenting with abdominal pain and PV bleed\/discharge in whom clinical signs of sepsis are present. Active surveillance should be considered in this patient group including septic abortion to capture the true prevalence of this emerging pathogen to inform preventative and therapeutic approaches.<\/jats:p>\n<\/jats:sec>","DOI":"10.1007\/s15010-019-01359-6","type":"journal-article","created":{"date-parts":[[2019,9,23]],"date-time":"2019-09-23T16:03:11Z","timestamp":1569254591000},"page":"285-288","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Non-typeable Haemophilus influenzae-associated early pregnancy loss: an emerging neonatal and maternal pathogen"],"prefix":"10.1007","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1133-3874","authenticated-orcid":false,"given":"Muge","family":"Cevik","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olga L.","family":"Moncayo-Nieto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margaret J.","family":"Evans","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2019,9,23]]},"reference":[{"key":"1359_CR1","doi-asserted-by":"publisher","first-page":"466","DOI":"10.1097\/INF.0b013e3181950c74","volume":"28","author":"G Barkai","year":"2009","unstructured":"Barkai G, Leibovitz E, Givon-Lavi N, Dagan R. Potential contribution by nontypable Haemophilus influenzae in protracted and recurrent acute otitis media. Pediatr Infect Dis J. 2009;28:466\u201371. \nhttps:\/\/doi.org\/10.1097\/INF.0b013e3181950c74\n\n.","journal-title":"Pediatr Infect Dis J"},{"key":"1359_CR2","doi-asserted-by":"publisher","first-page":"40","DOI":"10.1186\/1471-2334-12-40","volume":"12","author":"L Naranjo","year":"2012","unstructured":"Naranjo L, Suarez JA, DeAntonio R, et al. Non-capsulated and capsulated Haemophilus influenzae in children with acute otitis media in Venezuela: a prospective epidemiological study. BMC Infect Dis. 2012;12:40. \nhttps:\/\/doi.org\/10.1186\/1471-2334-12-40\n\n.","journal-title":"BMC Infect Dis"},{"key":"1359_CR3","doi-asserted-by":"publisher","first-page":"455","DOI":"10.3201\/eid1603.090290","volume":"16","author":"S Ladhani","year":"2010","unstructured":"Ladhani S, Slack MPE, Heath PT, von Gottberg A, Chandra M, Ramsay ME, et al. Invasive Haemophilus influenzae disease, Europe, 1996\u20132006. Emerg Infect Dis. 2010;16:455\u201363.","journal-title":"Emerg Infect Dis"},{"key":"1359_CR4","doi-asserted-by":"publisher","first-page":"3857","DOI":"10.1016\/j.vaccine.2011.03.059","volume":"29","author":"M Giufre","year":"2011","unstructured":"Giufre M, Cardines R, Caporali MG, Accogli M, D\u2019Ancona F, Cerquetti M. Ten years of Hib vaccination in Italy: prevalence of non-encapsulated Haemophilus influenzae among invasive isolates and the possible impact on antibiotic resistance. Vaccine. 2011;29:3857\u201362. \nhttps:\/\/doi.org\/10.1016\/j.vaccine.2011.03.059\n\n.","journal-title":"Vaccine"},{"key":"1359_CR5","doi-asserted-by":"publisher","first-page":"1281","DOI":"10.1016\/S1473-3099(14)70734-0","volume":"14","author":"J Van Eldere","year":"2014","unstructured":"Van Eldere J, Slack MPE, Ladhani SN, Cripps A. Non-typeable Haemophilus influenzae, an under-recognised pathogen. Lancet Infect Dis. 2014;14:1281\u201392.","journal-title":"Lancet Infect Dis"},{"key":"1359_CR6","doi-asserted-by":"publisher","first-page":"1786","DOI":"10.1093\/cid\/civ194","volume":"60","author":"S Collins","year":"2015","unstructured":"Collins S, Litt DJ, Flynn S, Ramsay M, Slack MPE, Ladhani SN. Neonatal invasive\u00a0Haemophilus influenzae\u00a0disease in england and wales: epidemiology, clinical characteristics, and outcome. Clin Infect Dis. 2015;60:1786\u201392. \nhttps:\/\/doi.org\/10.1093\/cid\/civ194\n\n.","journal-title":"Clin Infect Dis"},{"key":"1359_CR7","doi-asserted-by":"publisher","first-page":"1125","DOI":"10.1001\/jama.2014.1878","volume":"311","author":"S Collins","year":"2014","unstructured":"Collins S, Ramsay M, Slack MPE, et al. Risk of invasive\u00a0Haemophilus influenzae\u00a0infection during pregnancy and association with adverse fetal outcomes. JAMA. 2014;311:1125\u201332. \nhttps:\/\/doi.org\/10.1001\/jama.2014.1878\n\n.","journal-title":"JAMA"},{"key":"1359_CR8","unstructured":"WHO recommendations on maternal health: guidelines approved by the WHO Guidelines Review Committee. Geneva: World Health Organization; 2017 (WHO\/MCA\/17.10). Licence: CC BY-NC-SA 3.0 IGO. \nhttps:\/\/apps.who.int\/iris\/bitstream\/handle\/10665\/259268\/WHO-MCA-17.10-eng.pdf?sequence=1\n\n Accessed July 25 2019."},{"key":"1359_CR9","doi-asserted-by":"publisher","first-page":"183","DOI":"10.3109\/00365549109023398","volume":"23","author":"H Schonheyder","year":"1991","unstructured":"Schonheyder H, Ebbesen F, Grunnet N, Ejlertsen T. Non-capsulated Haemophilus influenzae in the genital flora of pregnant and post-puerperal women. Scand J Infect Dis. 1991;23:183\u20137.","journal-title":"Scand J Infect Dis"},{"key":"1359_CR10","doi-asserted-by":"publisher","first-page":"890","DOI":"10.1007\/s100960050425","volume":"18","author":"MA Martinez","year":"1999","unstructured":"Martinez MA, Ovalle A, Ulloa MT, Vidal RM. Role of Haemophilus influenzae in intra-amniotic infection in patients with preterm rupture of membranes. Eur J Clin Microbiol Infect Dis. 1999;18:890\u20132.","journal-title":"Eur J Clin Microbiol Infect Dis"},{"issue":"10","key":"1359_CR11","doi-asserted-by":"publisher","first-page":"e005123","DOI":"10.1099\/jmmcr.0.005123","volume":"4","author":"H Baba","year":"2017","unstructured":"Baba H, Kakuta R, Tomita H, Miyazoe M, Saito M, Oe C, Ishibashi N, Sogi M, Oshima K, Aoyagi T, Gu Y, Yoshida M, Tokuda K, Endo S, Yano H, Kaku M. The first case report of septic abortion resulting from \u03b2-lactamase-negative ampicillin-resistant non-typeable Haemophilus influenzae infection. 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