The impact of group B Streptococcus prophylaxis on early onset neonatal infections.
The impact of group B Streptococcus prophylaxis on early onset neonatal infections.
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DOI：
10.3233/npm-1363312
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发表时间：
2013
影响因子：
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通讯作者：
K. L. Ecker;P. Donohue;K. Kim;J. Shepard;S. W. Aucott
中科院分区：
文献类型：
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作者：
K. L. Ecker;P. Donohue;K. Kim;J. Shepard;S. W. Aucott
目的 确定自 B 族链球菌 (GBS) 预防开始以来，早发型新生儿感染的致病病原体和/或抗生素敏感性谱是否发生变化，并确定氨苄青霉素/青霉素耐药微生物的危险因素。研究设计 对 1990 年至 2007 年 7 日龄以内的 220 名血液、尿液或脑脊液细菌或真菌培养呈阳性的婴儿的数据进行了检查，并根据产时抗生素预防 (IAP) 实践将其分为三个时期。比较不同时期的病原体和抗生素耐药性。结果 随着时间的推移，GBS 感染的发病率显着下降，而其他病原体的发病率或抗生素耐药性的出现没有变化，包括极低出生体重人群。在回归分析中，氨苄青霉素耐药性与男性相关（OR 3.096）。结论 使用 IAP 后未发现出现抗生素耐药性病原体。先前研究中发现的微生物变化和抗生素耐药性增加可能是多因素造成的。需要进一步研究以继续降低常见早发病原体的发生率。
OBJECTIVE To determine if changes have occurred in the causative pathogens and/or antibiotic susceptibility profiles in early onset neonatal infections since initiation of group B Streptococcus (GBS) prophylaxis and to determine risk factors for ampicillin/penicillin resistant microorganisms. STUDY DESIGN Data on 220 infants with positive blood, urine, or cerebrospinal fluid cultures for bacteria or fungi at ≤seven days of age from 1990-2007 were examined and divided into three epochs, based on intrapartum antibiotic prophylactic (IAP) practices. Pathogens and antibiotic resistance were compared among epochs. RESULTS A significant decrease in the incidence of GBS infections occurred over time, with no change in the incidence of other pathogens or the emergence of antibiotic resistance, including the very low-birthweight population. In regression analysis, ampicillin resistance was associated with male gender (OR 3.096). CONCLUSIONS No emergence of antibiotic resistant pathogens was found following IAP use. Changing microorganisms and increasing antibiotic resistance found in prior studies are likely multifactorial. Further study is needed to continue to reduce the rates of common early onset pathogens.