Peripartum transmission of penicillin-resistant Streptococcus pneumoniae.
Streptococcus pneumoniae is a rarely recognized cause of neonatal sepsis. We present a recent case of S. pneumoniae bacteremia acquired on the first day of life in a neonate born at 30 weeks of gestation to a mother without prenatal care who had prolonged rupture of the membranes and received intravenous ampicillin prior to delivery. The isolate was resistant to penicillin, with a MIC of the drug of 4 microg/ml. The child responded to a 7-day course of intravenous vancomycin. S. pneumoniae was recovered from the vagina of the mother on a swab culture collected prior to delivery, and isolates from mother and child were confirmed to be identical on the basis of pulsed-field gel electrophoresis. Although neonatal sepsis due to the peripartum transmission of S. pneumoniae is rare, this case highlights the concern that increasing efforts to prevent group B streptococcus neonatal disease may lead to an increase in neonatal infections due to resistant organisms.
Department of Internal Medicine, University of Louisville, Louisville, Kentucky, USA. LJM3@CDC.GOV
L Clifford
LC
McDonald
Kris
K
Bryant
James
J
Snyder
D000328:Adult; D016470:Bacteremia / Q000209:etiology; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical; D010403:Penicillin Resistance; D011008:Pneumococcal Infections / Q000150:complications / Q000635:transmission*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000382:microbiology; D013296:Streptococcus pneumoniae / Q000145:classification / Q000187:drug effects / Q000235:genetics / Q000302:isolation & purification; D014621:Vagina / Q000382:microbiology