[Neonatal digestive implantation of streptococcus group B. Influence of antibiotic therapy].
Group B streptococcus (GBS) is an important cause of neonatal infection. Early-onset diseases are due to perinatal contamination. The epidemiology of late-onset infections is poorly known. Maternal colonization may be responsible for some of them. The relationships between neonatal colonization and late disease could be a colonization of the gut. The purpose of this 3 year-prospective study was to analyse the kinetics of gut colonization in neonates and the influence of antibiotherapy. One hundred and nineteen infants less than one month of age were included because of the presence of GBS in their gastric aspirates or GBS infection. Depending on the therapeutic strategy, the infants were separated into 3 groups: 1) amoxicillin plus aminoside greater than or equal to 10 days because of neonatal infection (28 infants), 2) same combination less than or equal to 5 days because a GBS infection was suspected but not confirmed (17 infants), 3) no antibiotics (77 infants). Fecal flora was regularly analysed by differential count. Antibiotics caused rapid disappearance of GBS from the gut. However, the same strain reappeared after stopping the antibiotics at a rate of 13.5%. Without antibiotics, GBS was implanted in 33% of cases. This difference of implantation rate is statistically significant (p less than 0.05). No GBS infection was observed in any infant after a follow-up examination of 6 months to 2 years. Among the clinical and bacteriological factors studied, adhesion only was correlated with the GBS implantation. These results allow to discuss therapeutic abstention in colonized infants without any signs of infection.
Floch
C
C
Service de Néonatologie, Hôpital Louis-Mourier, Colombes.
Butel
M J
MJ
Lejeune
C
C
Vincent
N
N
Foucher
E
E
Boussougant
Y
Y
Engelmann
P
P
D000667:Ampicillin / Q000008:administration & dosage / Q000627:therapeutic use*; D015331:Cohort Studies; D004066:Digestive System Diseases / Q000188:drug therapy* / Q000453:epidemiology; D004338:Drug Combinations; D005500:Follow-Up Studies; D005602:France / Q000453:epidemiology; D006801:Humans; D007231:Infant, Newborn; D009428:Netilmicin / Q000008:administration & dosage / Q000627:therapeutic use*; D011446:Prospective Studies; D013290:Streptococcal Infections / Q000188:drug therapy* / Q000453:epidemiology; D013292:Streptococcus agalactiae
D004338:Drug Combinations; D009428:Netilmicin; D000667:Ampicillin
Implantation digestive néonatale du streptocoque B. Influence de l'antibiothérapie.