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

被引：13
作者：
Ecker, K. L. [1 ]
Donohue, P. K. [2 ,3 ]
Kim, K. S. [4 ]
Shepard, J. A. [5 ]
Aucott, S. W. [5 ]
机构：
[1] Crozer Chester Med Ctr, Div Neonatol, Upland, PA 19013 USA
[2] Johns Hopkins Univ, Sch Med, Baltimore, MD USA
[3] Johns Hopkins Univ, Sch Publ Hlth, Baltimore, MD USA
[4] Johns Hopkins Univ, Sch Med, Div Pediat Infect Dis, Baltimore, MD USA
[5] Johns Hopkins Univ, Sch Med, Div Neonatol, Baltimore, MD USA
来源：
JOURNAL OF PERINATOLOGY | 2013年 / 33卷 / 03期
关键词：
group B Streptococcus (GBS); late onset neonatal infections; Escherichia colt (E. coli); Candida; antibiotic resistance; ESCHERICHIA-COLI SEPSIS; BLOOD-STREAM INFECTIONS; ANTIMICROBIAL RESISTANCE; NATIONAL INSTITUTE; CHILD HEALTH; RISK-FACTORS; DISEASE; EXPERIENCE; PATTERNS; INFANTS;
D O I：
10.1038/jp.2012.76
中图分类号：
R71 [妇产科学];
学科分类号：
100211 ;
摘要：
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 (LAP) 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 colt infections showed increasing ampicillin resistance over epochs (P = 0.006). In regression analysis, ampicillin/penicillin resistance increased with LAP 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. Journal of Perinatology (2013) 33, 206-211; doi:10.1038/jp.2012.76; published online 14 June 2012
引用
收藏
页码：206 / 211
页数：6
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