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

J Perinatol. 2013 Mar;33(3):206-11. doi: 10.1038/jp.2012.76. Epub 2012 Jun 14.

Abstract

Objective: To determine trends in late-onset neonatal infections and risk factors for ampicillin/penicillin-resistant microorganisms.

Study design: Data on 584 infants with positive blood, urine or cerebrospinal fluid cultures for bacteria or fungi at 8-30 days of age from 1990 to 2007 were examined and divided into three epochs, based on intrapartum antibiotic prophylactic (IAP) practices. Pathogens and antibiotic resistance were compared among epochs.

Result: The number of candidal infections increased over time for the entire population (P=0.006). There was an increased incidence of Gram-negative (P=0.009) and candidal infections (P=0.014) among very low-birthweight infants. Only Escherichia coli infections showed increasing ampicillin resistance over epochs (P=0.006). In regression analysis, ampicillin/penicillin resistance increased with IAP use (odds ratio 2.05).

Conclusion: Changing microorganisms and increasing antibiotic resistance in late-onset neonatal infections are likely multifactorial but are increased with IAP use, which may identify an at-risk population. Increasing Candida infections require further investigation.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age of Onset
  • Ampicillin Resistance*
  • Antibiotic Prophylaxis*
  • Cross Infection / epidemiology
  • Cross Infection / prevention & control
  • Escherichia coli Infections / prevention & control
  • Female
  • Humans
  • Infant, Newborn
  • Risk Factors
  • Streptococcal Infections / epidemiology*
  • Streptococcal Infections / prevention & control*
  • Streptococcus agalactiae*