[Neonatal bacterial infection by maternal-fetal contamination: for a change in approach? 2. Uncertainties and proposals].
Based on a critical analysis of the literature, it is clear that even though mortality has decreased to 10-15%, the prevalence of neonatal bacterial infections remains dramatically stable. Precise risk factors can be identified in most cases of neonatal infection, but remain uncertain in many others: Streptococcus agalactiae is found in only 40% of the cases of sepsis; Escherichia coli, Haemophilus influenzae, Pneumococcus, and group A Streptococcus strains should also be considered for a real prophylactic strategy; context (prematurity), lack of a consensual attitude for intrapartum strategies; management schemes for asymptomatic neonates. Based on these observations, we make proposals for a realistic attitude for everyday practice based on risk factors, maternal and neonatal bacterial sampling procedures, and modalities for neonatal antibiotic therapy.
Blond
M H
MH
Service de Médecine Néonatale, Centre de Pédiatrie Gatien-de-Clocheville, 49, boulevard Béranger, 37044 Tours.
Gold
F
F
Pierre
F
F
Quentin
R
R
Aujard
Y
Y
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001424:Bacterial Infections / Q000175:diagnosis / Q000517:prevention & control / Q000635:transmission*; D004927:Escherichia coli Infections / Q000175:diagnosis / Q000453:epidemiology / Q000635:transmission; D005260:Female; D006192:Haemophilus Infections / Q000175:diagnosis / Q000453:epidemiology / Q000635:transmission; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical; D011008:Pneumococcal Infections / Q000175:diagnosis / Q000453:epidemiology / Q000635:transmission; D011247:Pregnancy; D012307:Risk Factors; D013290:Streptococcal Infections / Q000175:diagnosis / Q000453:epidemiology / Q000635:transmission; D013292:Streptococcus agalactiae
D000900:Anti-Bacterial Agents