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J Pediatr. 2017 Nov;190:169-173.e1. doi: 10.1016/j.jpeds.2017.07.039.

Effects of Intrapartum Antibiotic Prophylaxis on Neonatal Acquisition of Group B Streptococci.

Author information

1
Division of Pediatrics, Yokohama Rosai Hospital, Yokohama, Japan; Department of Infectious Diseases, Keio University School of Medicine, Tokyo, Japan.
2
Department of Infectious Diseases, Keio University School of Medicine, Tokyo, Japan.
3
Division of Pediatrics, Yokohama Rosai Hospital, Yokohama, Japan.
4
Division of Pediatrics, Ota Memorial Hospital, Ota, Japan.
5
Division of Pediatrics, Asahikawa Kosei Hospital, Asahikawa, Japan.
6
Department of Laboratory Medicine, Keio University School of Medicine, Tokyo, Japan.

Abstract

OBJECTIVES:

To assess the incidence of colonization with group B streptococci (GBS) among neonates as influenced by maternal GBS carriage and intrapartum antibiotic prophylaxis (IAP).

STUDY DESIGN:

Between October 2014 and May 2015, nasopharyngeal and rectal swab samples were collected from 730 neonates at 1 week and 1 month after birth. GBS and capsular serotype were identified by real-time polymerase chain reaction and by culture. IAP at delivery was determined retrospectively from hospital records.

RESULTS:

Sixty-four neonates (8.8%) were GBS-positive by real-time polymerase chain reaction and culture. Among neonates born to mothers who were GBS carriers (n = 107), 94.4% (101/107) had maternal IAP; 19.6% nonetheless were GBS-positive, compared with 6.5% of neonates born to noncarrier mothers (P <.01). Among neonates born to mothers receiving IAP, more were positive only at 1 month of age than at both 1 week and 1 month. The frequency of GBS in neonates born to mothers receiving IAP was significantly lower than that in neonates born to mothers not receiving IAP (P <.05). Capsular serotypes V (25%) and III (23.4%) were common, followed by Ib (15.6%), Ia (14.1%), II (7.8%), IV (6.3%), nontypeable (4.7%), and VI and VIII (each 1.6%).

CONCLUSIONS:

Delayed colonization with GBS occurs in infants born to GBS carrier mothers receiving IAP. GBS should be considered in all infants at 1 month after birth with signs of infection.

KEYWORDS:

Streptococcus agalactiae; capsular serotype; maternal colonization; real-time PCR; vertical transmission

PMID:
29144242
DOI:
10.1016/j.jpeds.2017.07.039
[Indexed for MEDLINE]

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