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J Perinatol. 2013 Mar;33(3):206-11. doi: 10.1038/jp.2012.76. Epub 2012 Jun 14.

The impact of group B streptococcus prophylaxis on late-onset neonatal infections.

Author information

1
Division of Neonatology, Crozer Chester Medical Center, Upland, PA, USA. kelly.ecker@crozer.org

Abstract

OBJECTIVE:

To determine trends in late-onset neonatal infections and risk factors for ampicillin/penicillin-resistant microorganisms.

STUDY DESIGN:

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.

RESULT:

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).

CONCLUSION:

Changing microorganisms and increasing antibiotic resistance in late-onset neonatal infections are likely multifactorial but are increased with IAP use, which may identify an at-risk population. Increasing Candida infections require further investigation.

PMID:
22699358
DOI:
10.1038/jp.2012.76
[Indexed for MEDLINE]
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