The impact of group B Streptococcus prophylaxis on early onset neonatal infections.
OBJECTIVE
To determine if changes have occurred in the causative pathogens and/or antibiotic susceptibility profiles in early onset neonatal infections since initiation of group B Streptococcus (GBS) prophylaxis and to determine risk factors for ampicillin/penicillin resistant microorganisms.


METHODS
Data on 220 infants with positive blood, urine, or cerebrospinal fluid cultures for bacteria or fungi at ≤seven days of age from 1990-2007 were examined and divided into three epochs, based on intrapartum antibiotic prophylactic (IAP) practices. Pathogens and antibiotic resistance were compared among epochs.


RESULTS
A significant decrease in the incidence of GBS infections occurred over time, with no change in the incidence of other pathogens or the emergence of antibiotic resistance, including the very low-birthweight population. In regression analysis, ampicillin resistance was associated with male gender (OR 3.096).


CONCLUSIONS
No emergence of antibiotic resistant pathogens was found following IAP use. Changing microorganisms and increasing antibiotic resistance found in prior studies are likely multifactorial. Further study is needed to continue to reduce the rates of common early onset pathogens.
Division of Neonatology, Crozer Chester Medical Center, Upland, PA, USA.
K L
KL
Ecker
P K
PK
Donohue
K S
KS
Kim
J A
JA
Shepard
S W
SW
Aucott
D000328:Adult; D019072:Antibiotic Prophylaxis; D004352:Drug Resistance, Microbial; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D008297:Male; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy / Q000382:microbiology / Q000517:prevention & control*; D011295:Prenatal Care / Q000379:methods; D012307:Risk Factors; D018571:Sentinel Surveillance; D013290:Streptococcal Infections / Q000188:drug therapy / Q000382:microbiology / Q000517:prevention & control*; D013292:Streptococcus agalactiae / Q000472:pathogenicity*
Escherichia coli (E. coli); Group B Streptococcus (GBS); antibiotic resistance; early onset neonatal infections