title: Identification of sepsis in neonates following maternal antibiotic therapy.
abstract: To examine the value of current diagnostic tests identifying neonatal sepsis related to intrapartum treatment with antibiotics, we reviewed the charts of 219 mother-infant pairs, of which 139 mothers received intrapartum antibiotics (group 1) and 80 mothers did not (group 2). When compared with group 2 infants, group 1 infants had fewer positive blood cultures (4.3% vs 20%, P < 0.003), blood cultures positive for group B streptococci (GBS) (P < 0.001), and positive urine GBS latex agglutination (LA) tests (P < 0.001). Although the sensitivity of the white blood cell count (WBC) was 81%, the specificity was < 60% in both groups. The specificity of the urine GBS LA test was 92%. These results suggest (1) the WBC will neither confirm nor rule out neonatal septicemia; (2) blood cultures are indicated in suspected neonatal sepsis even if there was maternal intrapartum treatment with antibiotics; and (3) a urine GBS LA test is a useful adjunct in the diagnosis of neonatal GBS septicemia.
authors.affiliation: Department of Pediatrics, Medical College of Wisconsin, Milwaukee, USA.
authors.forename: R
authors.initials: R
authors.lastname: Heimler
authors.forename: L D
authors.initials: LD
authors.lastname: Nelin
authors.forename: D O
authors.initials: DO
authors.lastname: Billman
authors.forename: P
authors.initials: P
authors.lastname: Sasidharan
mesh_terms: D000667:Ampicillin / Q000008:administration & dosage*; D005260:Female; D005839:Gentamicins / Q000008:administration & dosage*; D006801:Humans; D007231:Infant, Newborn; D007743:Labor, Obstetric; D007841:Latex Fixation Tests; D007958:Leukocyte Count; D008431:Maternal-Fetal Exchange; D011247:Pregnancy; D012680:Sensitivity and Specificity; D018805:Sepsis / Q000175:diagnosis / Q000382:microbiology / Q000517:prevention & control*; D013292:Streptococcus agalactiae / Q000302:isolation & purification
chemical_list: D005839:Gentamicins; D000667:Ampicillin