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A Murine Model of Group B Streptococcus Vaginal Colonization
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A Murine Model of Group B Streptococcus Vaginal Colonization

Published on: November 16, 2016

The impact of group B streptococcus prophylaxis on late-onset neonatal infections

K L Ecker1, P K Donohue, K S Kim

  • 1Division of Neonatology, Crozer Chester Medical Center, Upland, PA, USA. kelly.ecker@crozer.org

Journal of Perinatology : Official Journal of the California Perinatal Association
|June 16, 2012
PubMed

Insights

Late-onset neonatal infections show changing pathogens and rising antibiotic resistance, particularly with intrapartum antibiotic prophylaxis (IAP) use. This suggests IAP may identify infants at higher risk for resistant infections.

Area of Science:

  • Neonatal Medicine
  • Infectious Diseases
  • Microbiology

Background:

  • Late-onset neonatal infections pose a significant challenge in neonatal intensive care units.
  • Antibiotic resistance is a growing concern in treating these infections.
  • Intrapartum antibiotic prophylaxis (IAP) practices have evolved, potentially influencing microbial trends.

Purpose of the Study:

  • To investigate trends in late-onset neonatal infections from 1990 to 2007.
  • To identify risk factors associated with ampicillin/penicillin-resistant microorganisms in neonates.
  • To assess the impact of intrapartum antibiotic prophylaxis (IAP) on infection patterns and resistance.

Main Methods:

  • Retrospective analysis of 584 infants with positive cultures (blood, urine, CSF) between 8-30 days of age.
  • Data divided into three epochs based on IAP practices.
  • Comparison of pathogens and antibiotic resistance patterns across epochs.

Main Results:

  • A significant increase in candidal infections observed over the study period (P=0.006).
  • Increased incidence of Gram-negative and candidal infections noted in very low-birthweight infants.
  • Escherichia coli demonstrated increasing ampicillin resistance over time (P=0.006); ampicillin/penicillin resistance correlated with IAP use (OR 2.05).

Conclusions:

  • Shifting microbial patterns and increasing antibiotic resistance in late-onset neonatal infections are multifactorial.
  • Intrapartum antibiotic prophylaxis (IAP) use is associated with increased resistance, potentially identifying at-risk neonates.
  • The rise in Candida infections warrants further investigation and targeted interventions.
Abstract

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