The impact of group B streptococcus prophylaxis on late-onset neonatal infections
Journal of Perinatology, 06/15/2012
Ecker KL et al. – Changing microorganisms and increasing antibiotic resistance in late–onset neonatal infections are likely multifactorial but are increased with intrapartum antibiotic prophylactic (IAP) use, which may identify an at–risk population. Increasing Candida infections require further investigation.Methods
- Data on 584 infants with positive blood, urine or cerebrospinal fluid cultures for bacteria or fungi at 8-30 days of age from 1990 to 2007 were examined and divided into three epochs, based on intrapartum antibiotic prophylactic (IAP) practices.
- Pathogens and antibiotic resistance were compared among epochs.
- The number of candidal infections increased over time for the entire population (P=0.006).
- There was an increased incidence of Gram-negative (P=0.009) and candidal infections (P=0.014) among very low-birthweight infants.
- Only Escherichia coli infections showed increasing ampicillin resistance over epochs (P=0.006).
- In regression analysis, ampicillin/penicillin resistance increased with IAP use (odds ratio 2.05).