{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T12:13:45Z","timestamp":1753877625215,"version":"3.41.2"},"reference-count":29,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2025,6,16]],"date-time":"2025-06-16T00:00:00Z","timestamp":1750032000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,6,30]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>In 2018, Lombardy's Fight Against Sepsis in Obstetrics group developed a regional sepsis management bundle for obstetric patients. This study aimed to evaluate the impact of this bundle on maternal and neonatal clinical outcomes and on process measures.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This multicenter, observational, retrospective study included data from pregnant and puerperal adult patients diagnosed with sepsis according to the Surviving Sepsis Campaign guidelines in 2 periods: May 2015 to May 2018 (prebundle) and July 2018 to January 2023 (postbundle).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Eighty women were included: 24 (30.0%) in the prebundle period and 56 (70.0%) in the postbundle period. The primary source of infection was urinary (40.0%), with Escherichia coli being the most common pathogen isolated from blood cultures. Regarding clinical outcomes, no deaths occurred in pre- and postbundle periods. For mothers, there was no significant difference in median length of stay between the groups, while neonatal intensive care unit admissions of neonates significantly decreased from 85.7% to 31.3% (P = .013). Regarding process measures, the only significant increase occurred in infectious disease specialist consultations in the postbundle period (75.0%) as compared with the prebundle period (50.0%, P = .029).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The implementation of a regional maternal sepsis management bundle did not significantly alter maternal outcomes but was associated with a reduction in neonatal intensive care unit admissions, although what role bundle implementation had in this change remains uncertain. More infectious disease consultations postbundle highlight the potential role of the bundle increasing sepsis awareness among physicians dealing with these patients.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ofid\/ofaf337","type":"journal-article","created":{"date-parts":[[2025,6,12]],"date-time":"2025-06-12T11:52:37Z","timestamp":1749729157000},"source":"Crossref","is-referenced-by-count":0,"title":["A Multicenter Study in Northern Italy to Evaluate the Impact of a Sepsis Bundle in Obstetric Settings: The SOS Study"],"prefix":"10.1093","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5939-9576","authenticated-orcid":false,"given":"Marta","family":"Colaneri","sequence":"first","affiliation":[{"name":"Department of Biomedical and Clinical Sciences, University of Milan , Milan ,","place":["Italy"]},{"name":"Centre for Multidisciplinary Research in Health Science, University of Milan , Milano ,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4988-0427","authenticated-orcid":false,"given":"Simona","family":"Biscarini","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico , Milan ,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-2981-9269","authenticated-orcid":false,"given":"Lara","family":"Tiranini","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, IRCCS Policlinico San Matteo Foundation , Pavia ,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rebecca","family":"Pesare","sequence":"additional","affiliation":[{"name":"S.C. Malattie Infettive, Fondazione IRCCS Policlinico San Matteo , Pavia ,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3425-9817","authenticated-orcid":false,"given":"Pietro","family":"Valsecchi","sequence":"additional","affiliation":[{"name":"S.C. Malattie Infettive, Fondazione IRCCS Policlinico San Matteo , Pavia ,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5246-928X","authenticated-orcid":false,"given":"Elena","family":"Seminari","sequence":"additional","affiliation":[{"name":"S.C. Malattie Infettive, Fondazione IRCCS Policlinico San Matteo , Pavia ,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arsenio","family":"Spinillo","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, IRCCS Policlinico San Matteo Foundation , Pavia ,","place":["Italy"]},{"name":"Dipartimento di Scienze Clinico-Chirurgiche, Diagnostiche e Pediatriche Universit\u00e0 di Pavia , Pavia ,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alessandra","family":"Bandera","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico , Milan ,","place":["Italy"]},{"name":"Department of Pathophysiology and Transplantation, University of Milan , Milan ,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Enrico Mario","family":"Ferrazzi","sequence":"additional","affiliation":[{"name":"Obstetrics Unit, Department of Mother, Child and Neonate, UOC Mangiagalli Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico , Milan ,","place":["Italy"]},{"name":"Department of Clinical Sciences and Community Health, University of Milan , Milan ,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6587-4794","authenticated-orcid":false,"given":"Andrea","family":"Gori","sequence":"additional","affiliation":[{"name":"Department of Biomedical and Clinical Sciences, University of Milan , Milan ,","place":["Italy"]},{"name":"Centre for Multidisciplinary Research in Health Science, University of Milan , Milano ,","place":["Italy"]},{"name":"Infectious Disease Unit II, Ospedale Luigi Sacco, ASST Fatebenefratelli Sacco , Milano ,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"Carenzi","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, ASST Lariana Ospedale Sant\u2019Anna , Como ,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luigi","family":"Pusterla","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, ASST Lariana Ospedale Sant\u2019Anna , Como ,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7825-4922","authenticated-orcid":false,"given":"Federico","family":"D\u2019Amico","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, ASST Grande Ospedale Metropolitano Niguarda , Milan ,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alessandro","family":"Raimondi","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, ASST Grande Ospedale Metropolitano Niguarda , Milan ,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Massimo","family":"Puoti","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, ASST Grande Ospedale Metropolitano Niguarda , Milan ,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elisa","family":"Vallicella","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Carlo Poma Hospital, ASST Mantova , Mantova ,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gianpaolo","family":"Grisolia","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Carlo Poma Hospital, ASST Mantova , Mantova ,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Salvatore","family":"Casari","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, ASST Ospedale Carlo Poma , Mantova ,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2127-4230","authenticated-orcid":false,"given":"Alice","family":"Zavatta","sequence":"additional","affiliation":[{"name":"Department of Woman, Mother and Neonate, V. 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