Effect of intrapartum antibiotic prophylaxis of group B streptococcus infection on the incidence and bacteriological profile of early-onset neonatal sepsis
PENG Zhou-Jie, BAO Lei
Department of Neonatology, Children's Hospital Affiliated to Chongqing Medical University/National Center for Clinical Medical Research on Child Health and Disease/Key Laboratory of Developmental Disorders in Children, Ministry of Education, Chongqing 400014, China
Abstract：Objective To study the effect of intrapartum antibiotic prophylaxis (IAP) of group B streptococcus (GBS) infection on the incidence and bacteriological profile of early-onset neonatal sepsis (EONS). Methods A retrospective analysis was performed on the medical data of 494 pregnant women with positive GBS screening results and 526 neonates born by these women. According to whether the pregnant woman received IAP, the neonates were divided into two groups: IAP (n=304) and control (n=222). The two groups were compared in terms of clinical indices, incidence rate of EONS, and distribution of pathogenic bacteria in blood culture. Results Compared with the control group, the IAP group had a significantly lower proportion of children with abnormal clinical manifestations (P<0.001) and a significantly lower incidence rate of EONS (P=0.022). In the IAP group, Escherichia coli (2.3%) was the most common type of pathogenic bacteria in blood culture of the neonates with EONS, while GBS (3.2%) was the most common type of pathogenic bacteria in the control group. The IAP group had a significantly higher detection rate of ampicillin-resistant Escherichia coli than the control group (P=0.029). Conclusions Although IAP can significantly reduce the incidence rate of EONS in neonates born to pregnant women with positive GBS screening results, the infection rate of ampicillin-resistant Escherichia coli may increase after IAP treatment. Therefore, it is needed to enhance the monitoring of blood culture results of neonates with EONS and timely adjust treatment plan according to drug susceptibility test results.
PENG Zhou-Jie,BAO Lei. Effect of intrapartum antibiotic prophylaxis of group B streptococcus infection on the incidence and bacteriological profile of early-onset neonatal sepsis[J]. CJCP, 2022, 24(1): 49-53.
Asghar S, Khan JA, Mahmood MS, et al. A cross-sectional study of group B Streptococcus-associated sepsis, coinfections, and antibiotic susceptibility profile in neonates in Pakistan[J]. Adv Neonatal Care, 2020, 20(4): E59-E69. PMID: 31996563. DOI: 10.1097/ANC.0000000000000701.
Centers for Disease Control and Prevention. Prevention of perinatal group B streptococcal disease: a public health perspective[J]. MMWR Recomm Rep, 1996, 45(RR-7): 1-24. PMID: 8637497.
Gao KK, Fu J, Guan XS, et al. Incidence, bacterial profiles, and antimicrobial resistance of culture-proven neonatal sepsis in South China[J]. Infect Drug Resist, 2019, 12: 3797-3805. PMID: 31819560. PMCID: PMC6899077. DOI: 10.2147/IDR.S223597.
Polin RA. Committee on Fetus and Newborn. Management of neonates with suspected or proven early-onset bacterial sepsis[J]. Pediatrics, 2012, 129(5): 1006-1015. PMID: 22547779. DOI: 10.1542/peds.2012-0541.
The American College of Obstetricians and Gynecologists:Women's Health Care Physicians. Prevention of group B streptococcal early-onset disease in newborns: ACOG committee opinion, number 782[J]. Obstet Gynecol, 2019, 134(1): 1. PMID: 31241599. DOI: 10.1097/AOG.0000000000003334.
Glaser MA, Hughes LM, Jnah A, et al. Neonatal sepsis: a review of pathophysiology and current management strategies[J]. Adv Neonatal Care, 2021, 21(1): 49-60. PMID: 32956076. DOI: 10.1097/ANC.0000000000000769.
Phares CR, Lynfield R, Farley MM, et al. Epidemiology of invasive group B streptococcal disease in the United States, 1999-2005[J]. JAMA, 2008, 299(17): 2056-2065. PMID: 18460666. DOI: 10.1001/jama.299.17.2056.
Kuhn P, Dheu C, Bolender C, et al. Incidence and distribution of pathogens in early-onset neonatal sepsis in the era of antenatal antibiotics[J]. Paediatr Perinat Epidemiol, 2010, 24(5): 479-487. PMID: 20670228. DOI: 10.1111/j.1365-3016.2010.01132.x.
