No increase in rates of early-onset neonatal sepsis by antibiotic-resistant group B Streptococcus in the era of intrapartum antibiotic prophylaxis.
OBJECTIVE
The aim of this study was to assess the rate of early-onset neonatal sepsis by antibiotic-resistant group B Streptococcus.


METHODS
The time-trend study was conducted at a tertiary care center over the following periods: no protocol for group B Streptococcus prophylaxis (1990 to 1992), risk-based protocol (1993 to 1996), and screening-based protocol (1997 to 2002).


RESULTS
A total of 120,952 neonates were born with 118 cases of group B Streptococcus early-onset neonatal sepsis. The rate of group B Streptococcus early-onset neonatal sepsis decreased significantly (from 2.0 to 1.1 to 0.4 per 1000 births, P < .0001). No group B Streptococcus isolate was resistant to ampicillin, penicillin, cefazolin, or vancomycin. From 1997 to 2002, there were 3 clindamycin-resistant group B Streptococcus isolates (14%). The rate of erythromycin-resistant group B Streptococcus early-onset neonatal sepsis did not change (from 0.14 to 0.03 to 0.08 per 1000 births, P = .6). However, cases of erythromycin-resistant group B Streptococcus early-onset neonatal sepsis accounted for an increasing proportion of the remaining cases of group B Streptococcus early-onset neonatal sepsis (from 7.0% to 2.6% to 23.8%, P = .07).


CONCLUSIONS
We found no increase in rates of antibiotic-resistant group B Streptococcus early-onset neonatal sepsis.
Chen
Katherine T
KT
Department of Obstetrics and Gynecology, College of Physicians and Surgeons, Mailman School of Public Health, Columbia University, New York, NY 10032, USA. ktc10@columbia.edu
Puopolo
Karen M
KM
Eichenwald
Eric C
EC
Onderdonk
Andrew B
AB
Lieberman
Ellice
E
D017668:Age of Onset; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D019072:Antibiotic Prophylaxis; D016470:Bacteremia / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D015331:Cohort Studies; D024881:Drug Resistance, Bacterial; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000517:prevention & control; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy* / Q000382:microbiology; D011336:Probability; D012189:Retrospective Studies; D018570:Risk Assessment; D017678:Sex Distribution; D013290:Streptococcal Infections / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D013292:Streptococcus agalactiae / Q000187:drug effects* / Q000302:isolation & purification
D000900:Anti-Bacterial Agents