Early-onset neonatal sepsis in the era of group B streptococcal prevention

Robert S. Baltimore, Sharon M. Huie, James I. Meek, Anne Schuchat, Katherine L O'Brien

Research output: Contribution to journalArticle

Abstract

Objective. To determine whether intrapartum antibiotic prophylaxis for neonatal group B streptococcal (GBS) disease has resulted in an increased rate of non-GBS or antibiotic-resistant early-onset invasive neonatal disease. Methods. Maternal and infant chart review of all infants with bacteria other than GBS isolated from blood or spinal fluid in 1996 through 1999 in 19 hospitals (representing 81% of in-state births to state residents) throughout Connecticut. Suspected cases were identified through clinical microbiology laboratory records or through International Classification of Diseases, Ninth Revision codes when microbiology records were incomplete. Results. Ninety-four cases of non-GBS early-onset sepsis or meningitis were detected between 1996 and 1999. The rate of GBS-related early-onset infection (days 0-6 of life) dropped from 0.61/1000 to 0.23/1000 births, but the annual rate of non-GBS sepsis remained steady, ranging from 0.65 to 0.68/1000 during the surveillance period. There was an increase in the proportion of Escherichia coli infections that were ampicillin resistant between 1996 and 1998, but the proportion decreased in 1999. Conclusion. There was no increase in the incidence of non-GBS early-onset neonatal infections between 1996 and 1999. Fluctuations in the annual incidence of E coli infections, including ampicillin-resistant infections, suggest the need for continuation of surveillance in Connecticut and expansion to monitor larger populations.

Original languageEnglish (US)
Pages (from-to)1094-1098
Number of pages5
JournalPediatrics
Volume108
Issue number5
DOIs
StatePublished - 2001
Externally publishedYes

Fingerprint

Escherichia coli Infections
Ampicillin
Microbiology
Infant, Newborn, Diseases
Sepsis
Infection
Antibiotic Prophylaxis
Birth Rate
Incidence
International Classification of Diseases
Meningitis
Mothers
Parturition
Anti-Bacterial Agents
Bacteria
Population
Neonatal Sepsis

Keywords

  • Bacterial infections
  • Bacterial infections/cause
  • Bacterial infections/prevention and control
  • Infant
  • Neonatal infections
  • Newborn
  • Premature
  • Sepsis

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Early-onset neonatal sepsis in the era of group B streptococcal prevention. / Baltimore, Robert S.; Huie, Sharon M.; Meek, James I.; Schuchat, Anne; O'Brien, Katherine L.

In: Pediatrics, Vol. 108, No. 5, 2001, p. 1094-1098.

Research output: Contribution to journalArticle

Baltimore, Robert S. ; Huie, Sharon M. ; Meek, James I. ; Schuchat, Anne ; O'Brien, Katherine L. / Early-onset neonatal sepsis in the era of group B streptococcal prevention. In: Pediatrics. 2001 ; Vol. 108, No. 5. pp. 1094-1098.
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abstract = "Objective. To determine whether intrapartum antibiotic prophylaxis for neonatal group B streptococcal (GBS) disease has resulted in an increased rate of non-GBS or antibiotic-resistant early-onset invasive neonatal disease. Methods. Maternal and infant chart review of all infants with bacteria other than GBS isolated from blood or spinal fluid in 1996 through 1999 in 19 hospitals (representing 81{\%} of in-state births to state residents) throughout Connecticut. Suspected cases were identified through clinical microbiology laboratory records or through International Classification of Diseases, Ninth Revision codes when microbiology records were incomplete. Results. Ninety-four cases of non-GBS early-onset sepsis or meningitis were detected between 1996 and 1999. The rate of GBS-related early-onset infection (days 0-6 of life) dropped from 0.61/1000 to 0.23/1000 births, but the annual rate of non-GBS sepsis remained steady, ranging from 0.65 to 0.68/1000 during the surveillance period. There was an increase in the proportion of Escherichia coli infections that were ampicillin resistant between 1996 and 1998, but the proportion decreased in 1999. Conclusion. There was no increase in the incidence of non-GBS early-onset neonatal infections between 1996 and 1999. Fluctuations in the annual incidence of E coli infections, including ampicillin-resistant infections, suggest the need for continuation of surveillance in Connecticut and expansion to monitor larger populations.",
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