Ten-Year Study on the Effect of Intrapartum Antibiotic Prophylaxis on Early Onset Group B Streptococcal and Escherichia coli Neonatal Sepsis in Australasia

Daley, Andrew J; Isaacs, David

doi:10.1097/01.inf.0000128782.20060.79

Cited by 85 publications

(92 citation statements)

References 24 publications

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“…Western Pacific Angstetra et al 65 Daley et al 66 May et al 67 Tiskumara et al 62 Tiskumara et al 62 Kim et al 68 Niduvaje et al 69 Subtotal (I 2 =54·7%, p=0·039)…”

Section: Eastern Mediterraneanmentioning

confidence: 99%

Group B streptococcal disease in infants aged younger than 3 months: systematic review and meta-analysis

Edmond¹,

Kortsalioudaki²,

Scott³

et al. 2012

The Lancet

524

457

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SummaryBackground Despite widespread use of intrapartum antibiotic prophylaxis, group B streptococcus remains a leading cause of morbidity and mortality in infants in Europe, the Americas, and Australia. However, estimates of disease burden in many countries outside of these regions is not available. We aimed to examine the current global burden of invasive disease and the serotype distribution of group B streptococcus isolates.

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“…Western Pacific Angstetra et al 65 Daley et al 66 May et al 67 Tiskumara et al 62 Tiskumara et al 62 Kim et al 68 Niduvaje et al 69 Subtotal (I 2 =54·7%, p=0·039)…”

Section: Eastern Mediterraneanmentioning

confidence: 99%

Group B streptococcal disease in infants aged younger than 3 months: systematic review and meta-analysis

Edmond¹,

Kortsalioudaki²,

Scott³

et al. 2012

The Lancet

524

457

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“…Specifically, questions have been raised regarding whether IAP results in higher incidences of EOS attributable to organisms other than GBS and whether it is associated with changes in rates of EOS caused by ampicillin-resistant organisms, particularly in VLBW infants. 2,[17][18][19][20][21][22] Our study is the largest single-center study of exclusively inborn neonates to address these questions. We found that the overall incidence of neonatal EOS decreased in the era of GBS IAP, among all newborns and among VLBW infants.…”

Section: Discussionmentioning

confidence: 99%

No Change in the Incidence of Ampicillin-Resistant, Neonatal, Early-Onset Sepsis Over 18 Years

Puopolo

Eichenwald

2010

Pediatrics

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WHAT'S KNOWN ON THIS SUBJECT:The incidence of neonatal EOS caused by GBS has decreased with widespread use of IAP. The overall impact of peripartum antibiotic treatment on the incidence and antibiotic resistance of other early-onset infections remains unclear. WHAT THIS STUDY ADDS:Despite increases in peripartum antibiotic exposure, neonatal EOS rates decreased for all infants, with no change in the incidence of ampicillin-resistant infections. These findings may be secondary to the use of penicillin G rather than ampicillin for GBS prophylaxis.abstract OBJECTIVE: The objective of this study was to assess the effect of maternal antibiotic exposure on neonatal early-onset sepsis (EOS) rates over an 18-year period. METHODS:A review was performed of infant and maternal records for all culture-proven cases of EOS in infants delivered at the Brigham and Women's Hospital (Boston, MA) in 1990 -2007. RESULTS:Data were analyzed from 335 EOS cases over periods that differed with respect to hospital policy for intrapartum antibiotic prophylaxis against group B Streptococcus (GBS) : 1990 -1992 (no prophylaxis); 1993-1996 (risk-based); and 1997-2007 (screening-based). The overall incidence of EOS decreased over these periods (3.70 vs 2.23 vs 1.59 cases per 1000 live births; P Ͻ .0001). No change in the incidence of infection with ampicillin-resistant organisms was observed overall or among very low birth weight infants. However, an increased proportion of infections were caused by ampicillin-resistant organisms. Mothers of infants with ampicillin-resistant infections were more likely to have been treated with ampicillin (P ϭ .0001). Overall peripartum antibiotic use increased during the study period primarily because of increased use of penicillin G and clindamycin, with no significant change in the use of ampicillin.CONCLUSIONS: Predominant use of penicillin G for GBS prophylaxis resulted in decreased incidence of EOS. No change in the incidence of ampicillin-resistant EOS was observed, but resistant cases were associated with peripartum ampicillin exposure. These findings suggest that obstetricians should consider preferential use of penicillin G for GBS prophylaxis. Pediatrics 2010;125:e1031-e1038

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“…These at-risk women are given intravenous antibiotics in labour to inhibit the transmission (Royal Australian and New Zealand College of Obstetricians and Gynaecologists, 2012; Reingold et al, 2007). As a result of intrapartum antibiotic prophylaxis, the incidence of early onset neonatal GBS disease in Australasia fell from 1.43 per 1000 live births in 1993 to 0.25 per 1000 live births in 2001 (Daley & Isaacs, 2004). However, there are disadvantages associated with the use of intravenous antibiotics.…”

Section: List Of Figuresmentioning

confidence: 99%

“…The disadvantages of giving intravenous antibiotics in labour include the development of antibiotic resistance in GBS and other bacteria, and the disruption of the early growth of good bacteria in the newborn's gut (Baltimore, 2007;Centers for Disease Control and Prevention, 2010;Cheng et al, 2006;Daley & Isaacs, 2004;Edwards, 2006;Grimwood et al, 2002;Ohlsson & Shah, 2013;Pattern et al, 2006;Rautava et al, 2012;Russel & Murch, 2006). In the United States and Canada, 20 to 35 per cent of labouring women now receive intravenous antibiotic prophylaxis (Baltimore, 2007;Centers for Disease Control and Prevention, 2010;Chen et al, 2005;Glasglow et al, 2005;Pattern et al, 2006).…”

Section: List Of Figuresmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The impact of oral probiotics on vaginal Group B Streptococcal colonisation rates in pregnant women: A pilot randomised control study

et al. 2018

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AimThe aim of this study was to complete a pilot project to ascertain if the research design was appropriate to determine whether a daily oral dose of probiotics can reduce the rate of vaginal group B streptococcal (GBS) colonisation in pregnancy. MethodologyA pilot randomised controlled trial was performed which recruited 34 GBS-positive women who were approximately 36 weeks pregnant. The participants were randomly allocated to the control group, who continued with standard antenatal care, or to the intervention group, which continued with standard antenatal care and received a daily oral dose of probiotics for three weeks or until the birth of their infant. A lower vaginal swab to detect the presence of GBS was collected three weeks post consent or when a participant was in labour. ResultsNo significant difference was found in vaginal GBS rates between the control and intervention groups. Only seven of 21 women in the intervention group completed the entire 21 days of probiotics. A subgroup analysis, including only those who had completed 14 days or more of probiotics (n=16), also showed no significant difference in vaginal GBS when compared to the control. As a secondary finding of the analysis did show significantly more vaginal commensals in the probiotics group (p=0.048).iii DiscussionThere are five possible reasons for the lack of significant results: The length of the intervention was too short. The dosage of the probiotics was too low. The wrong strains of probiotics were used. The sample size was inadequate. Oral probiotics are ineffective in impacting vaginal GBS. ImplicationsThe secondary finding of a significant increase of vaginal commensals (normal

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Ten-Year Study on the Effect of Intrapartum Antibiotic Prophylaxis on Early Onset Group B Streptococcal and Escherichia coli Neonatal Sepsis in Australasia

Abstract: The increasing use of intrapartum antibiotics produced a steady decline in EOGBS disease in Australasia. There was also a trend to decreasing EO E. coli sepsis in all babies, and the rate in very low birth weight infants remained stable.

Cited by 85 publications

References 24 publications

Group B streptococcal disease in infants aged younger than 3 months: systematic review and meta-analysis

Group B streptococcal disease in infants aged younger than 3 months: systematic review and meta-analysis

No Change in the Incidence of Ampicillin-Resistant, Neonatal, Early-Onset Sepsis Over 18 Years

The impact of oral probiotics on vaginal Group B Streptococcal colonisation rates in pregnant women: A pilot randomised control study

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