Maternal risk factors for perinatal septicemia due to the Enterobacteriaceae

Cases of perinatal septicemia due to the Enterobactericeae, which manifest in the first 24 hr of life were analyzed for the presence or absence of the maternal risk factors defined in the CDC group B streptococcus (GBS) risk-factor protocol. Microbiological data involving blood culture isolates were reviewed for the recovery of an Enterobacteriaceae from January 1975 through June 1995. Enterobacteriaceae perinatal septicemia was defined as the recovery an Enterobacteriaceae from one or more set of blood cultures in the first 24-36 hr of life in conjuncture with clinical evidence of neonatal stress in the first 24 hr. A case would also be considered of perinatal origin for cultures obtained up to 36 hr provided that evidence of clinical disease was present in the first 24 hr of life. Fifteen cases of perinatal septicemia due to the Enterobacteriaceae were analyzed. All but four shared one or more maternal risk factors. The maternal risk criteria established to avert early-onset GBS disease are commonly encountered in women destined to have newborns with perinatal septicemia due to the Enterobacteriaceae. Antibiotic selection for risk-driven protocols for GBS avoidance may need to be broadened to address the issue of coverage for penicillin-sensitive and penicillin-resistant Enterobacteriaceae.