No increase in rates of early-onset neonatal sepsis by non-group B Streptococcus or ampicillin-resistant organisms

Katherine T. Chen, Ruth E. Tuomala, Amy P. Cohen, Eric C. Eichenwald, Ellice Lieberman

Research output: Contribution to journalArticlepeer-review

40 Scopus citations

Abstract

OBJECTIVE: We assessed the impact of a risk-based approach to group B Streptococcus (GBS) prophylaxis on the rates of early-onset neonatal sepsis (EONS). STUDY DESIGN: A retrospective cohort study of neonates born at a tertiary-care hospital from 1990 to 1996 was performed. Cases of EONS were identified among neonates born in a period without GBS prophylaxis (1990-1992) and compared with those born in a period with GBS prophylaxis (1993-1996). The antibiotic susceptibility data on each organism isolated in the blood culture were obtained. RESULTS: In the period without prophylaxis, 99 cases of EONS were identified among 25,934 neonates for a rate of 3.8 per 1000 births. In the period with prophylaxis, 90 cases of EONS occurred among 34,262 neonates for a rate of 2.6 per 1000. The rate of GBS-EONS significantly decreased between the 2 periods (from 1.9 to 1.1, P=.01). There was a trend toward a decrease in the rate of EONS caused by non-GBS gram-positive organisms (from 1.2 to 0.7, P=.06). There was no significant increase in the rate of EONS caused by gram-negative or ampicillin-resistant organisms. CONCLUSIONS: A risk-based approach to GBS prophylaxis reduced the incidence of GBS-EONS at a tertiary-care hospital. This decrease was not accompanied by an increase in the incidence of EONS by non-GBS or ampicillin-resistant organisms.

Original languageEnglish
Pages (from-to)854-858
Number of pages5
JournalAmerican Journal of Obstetrics and Gynecology
Volume185
Issue number4
DOIs
StatePublished - 2001
Externally publishedYes

Keywords

  • Ampicillin resistance
  • Drug therapy
  • Escherichia coli
  • Group B Streptococcus
  • Pregnancy complications
  • Streptococcus agalactiae

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