The impact of group B Streptococcus prophylaxis on early onset neonatal infections

Ecker, K L; Donohue, Pamela; Kim, K S; Shepard, Jennifer; Aucott, Susan W.

doi:10.3233/npm-1363312

Cited by 12 publications

(5 citation statements)

References 19 publications

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“…Whether or not IAP alters infection rates of other pathogens or increases GBS antibiotic resistance remains unclear. Some studies have alerted to the possibility of negative IAP effects including increased infections with Gram-negative bacteria such as ampicillin-resistant E. coli ( 228 , 229 ), whereas others have not ( 230 ). A recent epidemiological study found an increase in GBS LOD from 1997–2001 to 2002–2010, but it is not known whether this is due to a shift in GBS pathogenicity, or due to an increase in survival of preterm infants, or delay in disease onset from IAP ( 226 ).…”

Section: Potential Unintended Consequences Of Iapmentioning

confidence: 99%

Group B Streptococcal Maternal Colonization and Neonatal Disease: Molecular Mechanisms and Preventative Approaches

2018

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Group B Streptococcus (GBS) colonizes the gastrointestinal and vaginal epithelium of a significant percentage of healthy women, with potential for ascending intrauterine infection or transmission during parturition, creating a risk of serious disease in the vulnerable newborn. This review highlights new insights on the bacterial virulence determinants, host immune responses, and microbiome interactions that underpin GBS vaginal colonization, the proximal step in newborn infectious disease pathogenesis. From the pathogen perspective, the function GBS adhesins and biofilms, β-hemolysin/cytolysin toxin, immune resistance factors, sialic acid mimicry, and two-component transcriptional regulatory systems are reviewed. From the host standpoint, pathogen recognition, cytokine responses, and the vaginal mucosal and placental immunity to the pathogen are detailed. Finally, the rationale, efficacy, and potential unintended consequences of current universal recommended intrapartum antibiotic prophylaxis are considered, with updates on new developments toward a GBS vaccine or alternative approaches to reducing vaginal colonization.

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Section: Potential Unintended Consequences Of Iapmentioning

confidence: 99%

Group B Streptococcal Maternal Colonization and Neonatal Disease: Molecular Mechanisms and Preventative Approaches

2018

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“…Following the guidelines for prevention of perinatal GBS disease with universal antenatal screening and/or intrapartum antibiotic prophylaxis for culturepositive and high-risk pregnant women, the incidence of neonatal EOD has significantly declined. 3,4 However, there is a substantial variability of GBS incidence rates worldwide; in several countries GBS disease affects a significant number of infants, while in others GBS burden remains low. 5-8…”

Section: Introductionmentioning

confidence: 99%

Changes in the Incidence and Epidemiology of Neonatal Group B Streptococcal Disease over the Last Two Decades in Crete, Greece

Vergadi

Manoura

Chatzakis

et al. 2018

Infectious Disease Reports

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Group B streptococcus (GBS) remains a leading cause of neonatal disease. However, GBS rates and prevention strategies vary considerably worldwide. Herein, we investigated the burden and epidemiological trends of neonatal GBS infections in our area (Greece) over the last two decades. We conducted a multicenter retrospective study that includes all cases of culture-proven GBS disease in infants <90 days old in the last 22 years. Neonatal GBS incidence was 0.17/1000 live births (95%CI: 0.11-0.21). A significant increase was noted during the second decade (0.23 vs 0.10/1000, P<0.05). Late onset disease (LOD) significantly increased during the second decade (0.08 vs 0.02, P<0.05). Infants in the LOD group had a higher risk of meningitis (RR 1.8, 95%CI: 1.23-2.71). Long-term neurological sequelae were reported in 42.8% of meningitis cases. The mortality rate was 8%. The incidence of neonatal GBS disease in our area is among the lowest reported, but an increase was noted the last decade mainly due a rise in the LOD. The burden of LOD, the mortality and long-term disability are still substantial, thus effective prevention strategies − including maternal vaccination for neonatal GBS − are needed.

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“…Ampicillin is a beta-lactam antibiotic frequently used to treat early and late-onset neonatal sepsis [ 248 , 249 ]. Li and Xie developed a PBPK model of ampicillin in neonates and pregnant women during the intrapartum period and indicated that 50 mg/kg ampicillin q8h was effective and safe for newborns, and that 1 g of ampicillin was adequate for intrapartum prophylaxis [ 188 ].…”

Section: Resultsmentioning

confidence: 99%

Physiologically Based Pharmacokinetic Modeling in Neonates: Current Status and Future Perspectives

Zhang,

Cao

et al. 2023

Pharmaceutics

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Rational drug use in special populations is a clinical problem that doctors and pharma-cists must consider seriously. Neonates are the most physiologically immature and vulnerable to drug dosing. There is a pronounced difference in the anatomical and physiological profiles be-tween neonates and older people, affecting the absorption, distribution, metabolism, and excretion of drugs in vivo, ultimately leading to changes in drug concentration. Thus, dose adjustments in neonates are necessary to achieve adequate therapeutic concentrations and avoid drug toxicity. Over the past few decades, modeling and simulation techniques, especially physiologically based pharmacokinetic (PBPK) modeling, have been increasingly used in pediatric drug development and clinical therapy. This rigorously designed and verified model can effectively compensate for the deficiencies of clinical trials in neonates, provide a valuable reference for clinical research design, and even replace some clinical trials to predict drug plasma concentrations in newborns. This review introduces previous findings regarding age-dependent physiological changes and pathological factors affecting neonatal pharmacokinetics, along with their research means. The application of PBPK modeling in neonatal pharmacokinetic studies of various medications is also reviewed. Based on this, we propose future perspectives on neonatal PBPK modeling and hope for its broader application.

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The impact of group B Streptococcus prophylaxis on early onset neonatal infections

Cited by 12 publications

References 19 publications

Group B Streptococcal Maternal Colonization and Neonatal Disease: Molecular Mechanisms and Preventative Approaches

Group B Streptococcal Maternal Colonization and Neonatal Disease: Molecular Mechanisms and Preventative Approaches

Changes in the Incidence and Epidemiology of Neonatal Group B Streptococcal Disease over the Last Two Decades in Crete, Greece

Physiologically Based Pharmacokinetic Modeling in Neonates: Current Status and Future Perspectives

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