title: Neonatal Nasopharyngeal Colonization with Group B Streptococcus and its Association with Clinical Sepsis.
abstract: Objective This study aims to determine whether nasopharyngeal (NP) colonization with group B streptococcus (GBS) is associated with early-onset clinical sepsis within 72 hours of birth, prolonged antibiotic duration, longer neonatal intensive care unit (NICU) stay, and delay in tolerating full feeds among neonates ≥ 35 weeks gestation. Study Design A retrospective cohort study of 192 NICU neonates admitted for sepsis evaluation. Based on their GBS colonization status, the mother-neonate pairs were divided into four groups of mother-negative neonate (baby)-positive (MNBP), mother-positive neonate-positive (MPBP), mother-positive neonate-negative (MPBN), and a reference group of mother-negative neonate-negative (MNBN). Neonates with GBS-positive blood cultures were excluded. Results The colonized neonate groups of MNBP (odds ratio [OR]: 21.8, 95% confidence interval [CI]: 7.99, 59.44) and MPBP (OR: 35.5, 95% CI: 9.57, 131.70) were each associated with increased odds for clinical sepsis (p < 0.001). A similar pattern occurred for prolonged antibiotic use. MPBP group was associated with the increased NICU stay (adjusted β: 0.1, standard error = 0.05, p < 0.01). None of the GBS groups were associated with increased days to full feeds. Conclusion Neonatal NP GBS colonization was found among a substantial proportion of GBS-negative mothers and was associated with an increased diagnosis of clinical sepsis.
authors.affiliation: Department of Pediatrics, Nassau University Medical Center, East Meadow, New York.
authors.forename: Anuj
authors.initials: A
authors.lastname: Malik
authors.affiliation: Department of Pediatrics, Nassau University Medical Center, East Meadow, New York.
authors.forename: Chetna
authors.initials: C
authors.lastname: Kothari
authors.affiliation: Department of Pediatrics, Nassau University Medical Center, East Meadow, New York.
authors.forename: Ammukutty
authors.initials: A
authors.lastname: Paulose
authors.affiliation: Department of Pediatrics, Nassau University Medical Center, East Meadow, New York.
authors.forename: Joshua
authors.initials: J
authors.lastname: Fogel
authors.affiliation: Department of Pediatrics, Nassau University Medical Center, East Meadow, New York.
authors.forename: Harriet
authors.initials: H
authors.lastname: Boxer
authors.affiliation: Department of Pediatrics, Nassau University Medical Center, East Meadow, New York.
authors.forename: Brinda
authors.initials: B
authors.lastname: Doraiswamy
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D007902:Length of Stay; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D009034:Mother-Child Relations; D009305:Nasopharynx / Q000382:microbiology; D015997:Neonatal Screening; D000071074:Neonatal Sepsis / Q000175:diagnosis* / Q000382:microbiology; D009518:New York; D016017:Odds Ratio; D012189:Retrospective Studies; D013290:Streptococcal Infections / Q000175:diagnosis* / Q000188:drug therapy; D013292:Streptococcus agalactiae / Q000302:isolation & purification*
chemical_list: D000900:Anti-Bacterial Agents