Early-onset neonatal sepsis and the implementation of group B streptococcus prophylaxis in a Brazilian maternity hospital: a descriptive study

Braz J Infect Dis. Jan-Feb 2017;21(1):92-97. doi: 10.1016/j.bjid.2016.09.013. Epub 2016 Nov 19.

Abstract

Objectives: To describe early-onset neonatal sepsis (EOS) epidemiology in a public maternity hospital in Brasilia, Brazil.

Methods: We defined EOS as a positive blood culture result obtained from infants aged ≤72 hours of life plus treatment with antibiotic therapy for ≥5 days. Incidence was calculated based on the number of cases and total live births (LB). This is a descriptive study comparing the period of 2012-2013 with the period of 2014-September 2015, before and after implementation of antibiotic prophylaxis during labor for group B streptococcus (GBS) prevention, respectively.

Results: Overall, 36 infants developed EOS among 21,219 LB (1.7 cases per 1000 LB) and 16 died (case fatality rate of 44%). From 2014, 305 vaginal-rectal swabs were collected from high-risk women and 74 (24%) turned out positive for GBS. After implementation of GBS prevention guidelines, no new cases of GBS were detected, and the EOS incidence was reduced from 1.9 (95% CI 1.3-2.8) to 1.3 (95% CI 0.7-2.3) cases per 1000 LB from 2012-2013 to 2014-September 2015 (p=0.32).

Conclusions: Although the reduction of EOS incidence was not significant, GBS colonization among pregnant women was high, no cases of neonatal GBS have occurred after implementation of prevention guidelines.

Keywords: Brazil; Escherichia coli infection; Group B streptococcal disease; Neonatal sepsis.

MeSH terms

  • Antibiotic Prophylaxis / methods*
  • Brazil / epidemiology
  • Escherichia coli / drug effects
  • Escherichia coli / isolation & purification
  • Escherichia coli Infections / epidemiology
  • Escherichia coli Infections / prevention & control
  • Female
  • Hospitals, Maternity
  • Humans
  • Incidence
  • Male
  • Neonatal Sepsis / epidemiology*
  • Neonatal Sepsis / microbiology
  • Neonatal Sepsis / prevention & control*
  • Pregnancy
  • Pregnancy Complications, Infectious / epidemiology*
  • Pregnancy Complications, Infectious / microbiology
  • Reproducibility of Results
  • Risk Factors
  • Streptococcal Infections / epidemiology*
  • Streptococcal Infections / prevention & control*
  • Streptococcus / drug effects*
  • Streptococcus / isolation & purification
  • Treatment Outcome
  • Vaginal Smears