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Journal articles on the topic 'Intrapartum antibiotic prophylaxis'

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Author: Grafiati

Published: 10 December 2022

Last updated: 28 January 2023

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1

Edwards, Rodney K., Penny Clark, Christopher L. Sistrom, and Patrick Duff. "Intrapartum Antibiotic Prophylaxis 1." Obstetrics & Gynecology 100, no. 3 (September 2002): 534–39. http://dx.doi.org/10.1097/00006250-200209000-00021.

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Edwards, Rodney K., Penny Clark, and Patrick Duff. "Intrapartum Antibiotic Prophylaxis 2." Obstetrics & Gynecology 100, no. 3 (September 2002): 540–44. http://dx.doi.org/10.1097/00006250-200209000-00022.

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3

Desravines, Nerlyne, Kartik K. Venkatesh, Austin Hopkins, Jamie Waldron, Megan Grant, Colleen McGuire, and Kim A. Boggess. "Intrapartum Group B Streptococcus Antibiotic Prophylaxis in Penicillin Allergic Pregnant Women." American Journal of Perinatology Reports 09, no. 03 (July 2019): e238-e243. http://dx.doi.org/10.1055/s-0039-1694031.

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Objectives To estimate the prevalence of and identify modifiable risk factors for alternative antibiotics for group B Streptococcus (GBS) prophylaxis in penicillin-allergic women. Methods Retrospective cohort study of pregnant women within a health care network from January 1, 2014, to December 31, 2017. Included women were GBS colonized, delivered at ≥ 37 weeks' gestation, and reported penicillin/cephalosporin allergy. The primary outcome was the use of alternate antibiotics GBS prophylaxis, defined per Centers for Disease Control and Prevention guidelines as antibiotics other than penicillin, ampicillin, or cefazolin. Results We identified 190 GBS-colonized pregnant women self-reporting a penicillin/cephalosporin allergy; 5% reported anaphylaxis, 44% high-risk symptoms (isolated hives, shortness of breath, swelling, or vomiting), and 51% low-risk symptoms (isolated rash, itching, or nausea). Two-thirds (63%) had alternative antibiotic prophylaxis. In adjusted analyses, nonwhite race (adjusted odds ratio [aOR]: 2.42; 95% confidence interval [CI]: 1.19–4.94) and high-risk allergic reaction (aOR: 2.42; 95% CI: 1.30–4.49) were associated with higher odds of alternative antibiotics prophylaxis compared with low-risk allergic reaction. Low-risk allergic reaction group was less likely to receive alternative antibiotic prophylaxis (aOR: 0.36; 95 CI%: 0.19–0.66). Conclusion Alternative antibiotic use for GBS prophylaxis is frequent with penicillin/cephalosporin allergies. Efforts to confirm allergy and perform penicillin hypersensitivity testing may increase compliance with guidelines for antibiotic administration.

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Nikonov, A. P., N. S. Naumenko, O. R. Astsaturova, A. V. Belova, and L. S. Aleksandrov. "Prevention of neonatal infection caused by group B streptococci." Voprosy ginekologii, akušerstva i perinatologii 19, no. 6 (2020): 12–16. http://dx.doi.org/10.20953/1726-1678-2020-6-12-16.

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Objective. To evaluate the prevalence of vaginal carriage of Streptococcus agalactiae among pregnant women at 35–37 weeks of gestation and assess the efficacy of intrapartum antibiotic prophylaxis (IAP) for group B streptococcus (GBS) infection in newborns. Patients and methods. We examined 800 pregnant women at 35–37 weeks of gestation (bacteriological examination of vaginal microbiota with biomaterial collected from the posterior vaginal fornix). Identified carriers of S. agalactiae who had vaginal delivery (n = 50) received antibiotic prophylaxis to prevent infection in newborns. We also evaluated the frequency of vertical transmission of streptococci in all infants during the first hour of life (bacteriological examination of pharyngeal swabs and meconium). Identification of microorganisms was performed by direct protein profiling using MALDI-TOF mass spectrometry (FLEX series, Bruker Daltonic GmbH, Germany). Results. Maternal vaginal colonization with S. agalactiae in the third trimester was observed in 13.5% of patients tested (n = 108). Fifty women had vaginal delivery and received antibiotic prophylaxis to prevent infection in newborns. Postpartum samples of only 1 newborn gave scanty growth of S. agalactiae at bacteriological examination (1 × 101 CFU/mL in meconium and 1 × 103 CFU/mL in the pharyngeal sample), while the remaining 49 newborns had sterile samples. Thus, the frequency of S. agalactiae vertical transmission with intrapartum antibiotic prophylaxis was 2% (n = 1). Of note, infection in the newborn caused no inflammation. Conclusion. Relatively low prevalence of vaginal carriage of S. agalactiae among pregnant women gives no sufficient grounds for the inclusion of such bacteriological examination into compulsory screening for infections in pregnant women in the Russian Federation. However, intrapartum antibiotic prophylaxis is an effective method to prevent streptococcal infection in newborns; it should be used in women at risk of GBS infections. Kew words: vaginal carriage of bacteria, intrapartum antibiotic prophylaxis, neonatal sepsis, Streptococcus agalactiae, intrauterine infection, screening for infections

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Koebnick, Corinna, Margo A. Sidell, Darios Getahun, Sara Y. Tartof, Emily Rozema, Brianna Taylor, Anny H. Xiang, et al. "Intrapartum Antibiotic Exposure and Body Mass Index in Children." Clinical Infectious Diseases 73, no. 4 (January 25, 2021): e938-e946. http://dx.doi.org/10.1093/cid/ciab053.

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Abstract Background Intrapartum antibiotic prophylaxis (IAP) reduces a newborn’s risk of group B streptococcal infection (GBS) but may lead to an increased childhood body mass index (BMI). Methods This was a retrospective cohort study of infants (n = 223 431) born 2007–2015 in an integrated healthcare system. For vaginal delivery, we compared children exposed to GBS-IAP and to any other type or duration of intrapartum antibiotics to no antibiotic exposure. For cesarean delivery, we compared children exposed to GBS-IAP to those exposed to all other intrapartum antibiotics, including surgical prophylaxis. BMI over 5 years was compared using nonlinear multivariate models with B-spline functions, stratified by delivery mode and adjusted for demographics, maternal factors, breastfeeding, and childhood antibiotic exposure. Results In vaginal deliveries, GBS-IAP was associated with higher BMI from 0.5 to 5.0 years of age compared to no antibiotics (P < .0001 for all time points, ΔBMI at age 5 years 0.12 kg/m2, 95% confidence interval [CI]: .07–.16 kg/m2). Other antibiotics were associated with higher BMI from 0.3 to 5.0 years of age. In cesarean deliveries, GBS-IAP was associated with increased BMI from 0.7 years to 5.0 years of age (P < .05 for 0.7–0.8 years, P < .0001 for all other time points) compared to other antibiotics (ΔBMI at age 5 years 0.24 kg/m2, 95% CI: .14–.34 kg/m2). Breastfeeding did not modify these associations. Conclusions GBS-IAP was associated with a small but sustained increase in BMI starting at very early age. This association highlights the need to better understand the effects of perinatal antibiotic exposure on childhood health.

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Daniels, Jane, Emily F. Dixon, Alicia Gill, Jon Bishop, Maria D’Amico, Khaled Ahmed, Julie Dodds, et al. "A rapid intrapartum test for group B Streptococcus to reduce antibiotic usage in mothers with risk factors: the GBS2 cluster RCT." Health Technology Assessment 26, no. 12 (February 2022): 1–82. http://dx.doi.org/10.3310/bicf1187.

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Background Mother-to-baby transmission of group B Streptococcus (Streptococcus agalactiae) is the main cause of early-onset infection. Objectives We investigated if intrapartum antibiotic prophylaxis directed by a rapid intrapartum test reduces maternal and neonatal antibiotic use, compared with usual care (i.e. risk factor-directed antibiotics), among women with risk factors for vertical group B Streptococcus transmission, and examined the accuracy and cost-effectiveness of the rapid test. Design An unblinded cluster randomised controlled trial with a nested test accuracy study, an economic evaluation and a microbiology substudy. Setting UK maternity units were randomised to either a strategy of rapid test or usual care. Participants Vaginal and rectal swabs were taken from women with risk factors for vertical group B Streptococcus transmission in established term labour. The accuracy of the GeneXpert® Dx IV GBS rapid testing system (Cepheid, Maurens-Scopont, France) was compared with the standard of selective enrichment culture in diagnosing maternal group B Streptococcus colonisation. Main outcome measures Primary outcomes were rates of intrapartum antibiotic prophylaxis administered to prevent early-onset group B Streptococcus infection and accuracy estimates of the rapid test. Secondary outcomes were maternal antibiotics for any indication, neonatal antibiotic exposure, maternal antibiotic duration, neonatal group B Streptococcus colonisation, maternal and neonatal antibiotic resistance, neonatal morbidity and mortality, and cost-effectiveness of the strategies. Results Twenty-two maternity units were randomised and 20 were recruited. A total of 722 mothers (749 babies) participated in rapid test units and 906 mothers (951 babies) participated in usual-care units. There were no differences in the rates of intrapartum antibiotic prophylaxis for preventing early-onset group B Streptococcus infection in the rapid test units (41%, 297/716) compared with the usual-care units (36%, 328/906) (risk ratio 1.16, 95% confidence interval 0.83 to 1.64). There were no differences between the groups in intrapartum antibiotic administration for any indication (risk ratio 0.99, 95% confidence interval 0.81 to 1.21). Babies born in the rapid test units were 29% less likely to receive antibiotics (risk ratio 0.71, 95% confidence interval 0.54 to 0.95) than those born in usual-care units. The sensitivity and specificity of the rapid test were 86% (95% confidence interval 81% to 91%) and 89% (95% confidence interval 85% to 92%), respectively. In 14% of women (99/710), the rapid test was invalid or the machine failed to provide a result. In the economic analysis, the rapid test was shown to be both less effective and more costly and, therefore, dominated by usual care. Sensitivity analysis indicated potential lower costs for the rapid test strategy when neonatal costs were included. No serious adverse events were reported. Conclusions The Group B Streptococcus 2 (GBS2) trial found no evidence that the rapid test reduces the rates of intrapartum antibiotic prophylaxis administered to prevent early-onset group B Streptococcus infection. The rapid test has the potential to reduce neonatal exposure to antibiotics, but economically is dominated by usual care. The accuracy of the test is within acceptable limits. Future work The role of routine testing for prevention of neonatal infection requires evaluation in a randomised controlled trial. Trial registration Current Controlled Trials ISRCTN74746075. Funding This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 26, No. 12. See the NIHR Journals Library website for further project information.

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Faro, Sebastian, Brenda Brehm, Frances Smith, Melanie Mouzoon, Anthony Greisinger, Oscar Wehmanen, and Mark A. Turrentine. "Screening for Group B Streptococcus: A Private Hospital's Experience." Infectious Diseases in Obstetrics and Gynecology 2010 (2010): 1–4. http://dx.doi.org/10.1155/2010/451096.

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Objective. To assess the effect of universal screening and administration of intrapartum antibiotic prophylaxis to prevent early-onset neonatal GBS sepsis at a private tertiary care hospital since issuance of the 2002 CDC guidelines for preventing perinatal GBS disease.Methods. Retrospective analysis of women delivering between January 1, 2003 and December 31, 2004 at a private tertiary care hospital in Houston, Texas. The percentage of women screened, GBS positive women receiving intrapartum antibiotic prophylaxis, and infants developing early-onset GBS sepsis were determined.Results. 2,108 women delivered 2,135 infants with 1,874 (89%) screened for GBS. Of those screened, 1,322 (71%) tested negative and 552 (29%) tested positive for GBS. In this analysis of 2,135 infants, 3 (0.94 cases/1,000 live births) were diagnosed with invasive GBS sepsis.Conclusion. High rates of screening of pregnant women for GBS colonization and use of intrapartum antibiotic prophylaxis for GBS carriers can be achieved in a private tertiary care hospital setting. “Synopsis: High screening rates for group B streptococcus in a private tertiary care hospital reduce the incidence of maternal and early onset neonatal GBS infection.”

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8

Edwards, R. K. "Intrapartum Antibiotic Prophylaxis: Making an Evidence-Based Selection." PEDIATRICS 117, no. 1 (January 1, 2006): 255–56. http://dx.doi.org/10.1542/peds.2005-2333.

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Berardi, Alberto, Fabrizio Ferrari, and Fabio Facchinetti. "Intrapartum antibiotic prophylaxis for Group B Streptococcus and risks of unnecessary antibiotics." American Journal of Obstetrics and Gynecology 212, no. 3 (March 2015): 408. http://dx.doi.org/10.1016/j.ajog.2014.11.001.

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Paccione, Kimberly A., and Harold C. Wiesenfeld. "Guideline Adherence for Intrapartum Group B Streptococci Prophylaxis in Penicillin-Allergic Patients." Infectious Diseases in Obstetrics and Gynecology 2013 (2013): 1–6. http://dx.doi.org/10.1155/2013/917304.

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Objective. To investigate adherence to the 2002 Centers for Disease Control and Prevention (CDC) guidelines for perinatal group B streptococci (GBS) prevention in penicillin-allergic obstetric patients.Methods. This is a retrospective cohort study of penicillin-allergic obstetric patients who tested positive for GBS and delivered at our institution in 2010. Electronic medical records were reviewed for the nature of the penicillin allergy, documentation of having previously tolerated cephalosporins, gestational age at delivery, type of delivery, antimicrobial sensitivity testing, and antibiotics administered. Antimicrobial sensitivity testing and “appropriate” antibiotic choice, which was determined using 2002 CDC guidelines, were analyzed.Results. Intrapartum antibiotic prophylaxis was administered in 97.8% (95% confidence interval [CI] 93.5–99.5%) of patients, but it was considered appropriate in only 62.2% (95% CI 53.8–70.0%) of patients. Clindamycin was the most commonly used antibiotic, but 26.4% (95% CI 16.3–39.7%) of patients who received clindamycin did not have confirmation of susceptibility via antimicrobial sensitivity testing. Overall, the sensitivity testing was performed in only 65.5% (95% CI 56.2–73.7%) of patients in whom it was indicated.Conclusion. Compliance with CDC guidelines for performing antimicrobial sensitivity testing and choosing an appropriate antibiotic in GBS-positive penicillin-allergic women continues to be suboptimal. Institution of measures to increase adherence is necessary.

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Reiff, Emily S., Ashraf S. Habib, Brendan Carvalho, and Karthik Raghunathan. "Antibiotic Prophylaxis for Cesarean Delivery: A Survey of Anesthesiologists." Anesthesiology Research and Practice 2020 (December 16, 2020): 1–5. http://dx.doi.org/10.1155/2020/3741608.

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Background. The most common complication after cesarean delivery is surgical site infection. Antibiotic prophylaxis reduces infectious morbidity and current anesthetic quality metrics include preincision antibiotic prophylaxis. Recently, studies suggest reductions in infectious morbidity with the addition of azithromycin for unscheduled cesarean delivery. Larger doses of cefazolin are recommended for morbidly obese women, but evidence is conflicting. The aim of this study was to survey anesthesiologists to assess current practice for antibiotic prophylaxis for cesarean delivery. Methods. We invited a random sample of 10,000 current members of the American Society of Anesthesiologists to complete an online survey about their current practice of antibiotic prophylaxis for cesarean delivery in November 2017. The survey included questions similar to a previous survey on this topic in 2012. Results. The response rate was 12.2% (n = 1223). Most respondents had at least 15 years of experience (684, 55.9%), work at a nonteaching or community hospital (729, 59.6%), with >500 cesarean deliveries annually (619, 50.6%), and administer obstetric anesthesia several times a week (690, 56.4%). Routine preincision antibiotic prophylaxis was reported by 1162 (95.0%) of the 1223 respondents, a substantial improvement versus the 63.5% reported in the previous study in 2012. For intrapartum cesarean deliveries, 141 (11.5%) administer azithromycin for unscheduled cesarean deliveries. Those who use cefazolin, 509 (42.5%) administer 3 g for morbidly obese women. Conclusion. Adherence to preincision antibiotic prophylaxis for cesarean delivery is very high, a significant improvement within 5 years. A minority of anesthesiologists utilize azithromycin for intrapartum cesarean deliveries. The dose of cefazolin for morbidly obese women varies widely.

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Edwards, Rodney K., Whitney E. Jamie, Donald Sterner, Susan Gentry, Kathy Counts, and Patrick Duff. "Intrapartum Antibiotic Prophylaxis and Early-Onset Neonatal Sepsis Patterns." Infectious Diseases in Obstetrics and Gynecology 11, no. 4 (2003): 221–26. http://dx.doi.org/10.1080/10647440300025525.

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Corvaglia, L., E. Legnani, D. D. Gioia, I. Aloisio, S. Martini, M. Oss, B. Biavati, and G. Faldella. "1334 Effects of Intrapartum Antibiotic Prophylaxis on Newborn Microbiota." Archives of Disease in Childhood 97, Suppl 2 (October 1, 2012): A380. http://dx.doi.org/10.1136/archdischild-2012-302724.1334.

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Bienenfeld, Sarah, Laura G. Rodriguez-Riesco, and Kent D. Heyborne. "Avoiding Inadequate Intrapartum Antibiotic Prophylaxis for Group B Streptococci." Obstetrics & Gynecology 128, no. 3 (September 2016): 598–603. http://dx.doi.org/10.1097/aog.0000000000001564.

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Scasso, Santiago, Joel Laufer, Grisel Rodriguez, Justo G. Alonso, and Claudio G. Sosa. "Vaginal group B streptococcus status during intrapartum antibiotic prophylaxis." International Journal of Gynecology & Obstetrics 129, no. 1 (December 18, 2014): 9–12. http://dx.doi.org/10.1016/j.ijgo.2014.10.018.

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Liu, Ping, Qiaoli Feng, Yiheng Liang, Xinxin Wang, Zhansong Xiao, Liting Huang, Yun Li, et al. "Maternal Group B Streptococcal Rectovaginal Colonization after Intrapartum Antibiotic Prophylaxis." Children 9, no. 12 (November 28, 2022): 1848. http://dx.doi.org/10.3390/children9121848.

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Maternal rectovaginal colonization with Group B Streptococcus (GBS) during labor is a prerequisite for neonatal early-onset GBS disease. Intrapartum antibiotic prophylaxis (IAP) has been proven to prevent GBS perinatal infection, while there are few studies on the evaluation of the effectiveness of different antibiotic prophylaxis regimens. This study aimed to assess the maternal rectovaginal GBS colonization status after IAP, antimicrobial susceptibility and maternal and neonatal outcomes among women administered different antibiotic prophylaxis regimens. A prospective study was conducted between June 2018 and June 2022. GBS carriers identified at 35–37 weeks of gestation were provided IAP (penicillin, cefazolin or clindamycin) at delivery based on the local protocol for GBS prevention. Rectovaginal samples were obtained from participants again after delivery. Antimicrobial susceptibility testing in GBS isolates was performed using the broth microdilution method. A total of 295 cases were included in this study. In the postpartum re-examination for GBS, the overall negative rectovaginal culture rate was 90.8% (268/295). Women who received cefazolin prophylaxis had the highest negative culture rate (95.2%, 197/207), which was followed by those who received penicillin (80.7%, 67/83) and clindamycin (80.0%, 4/5) (p = 0.001). All GBS isolates achieved sensitivity to penicillin and cefazolin, whereas resistance to clindamycin was shown in 21.4% of the strains. There were no significant differences in maternal and neonatal outcomes among the IAP groups. The use of IAP is highly effective in reducing the maternal rectovaginal GBS colonization. Cefazolin may offer equivalent efficacy and safety compared to standard penicillin prophylaxis.

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Edwards, R. "Intrapartum antibiotic prophylaxis 1: relative effects of recommended antibiotics on gram-negative pathogens." Obstetrics & Gynecology 100, no. 3 (September 2002): 534–39. http://dx.doi.org/10.1016/s0029-7844(02)02096-3.

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Glasgow, T. S. "Intrapartum Antibiotic Prophylaxis: Making an Evidence-Based Selection: In Reply." PEDIATRICS 117, no. 1 (January 1, 2006): 256–57. http://dx.doi.org/10.1542/peds.2005-2431.

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Di Renzo, G. C., P. Melin, A. Berardi, M. Blennow, X. Carbonell-Estrany, G. P. Donzelli, S. Hakansson, et al. "Intrapartum GBS screening and antibiotic prophylaxis: a European consensus conference." Journal of Maternal-Fetal & Neonatal Medicine 28, no. 7 (August 27, 2014): 766–82. http://dx.doi.org/10.3109/14767058.2014.934804.

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Cate, Jennifer, Jessica Lee Illuzzi, and Colby Cayton. "Duration of Intrapartum Antibiotic Prophylaxis for Group B Streptococcus [06A]." Obstetrics & Gynecology 135 (May 2020): 10S. http://dx.doi.org/10.1097/01.aog.0000662980.62212.d9.

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Gilbert, Gwendolyn L., Moira C. Hewitt, Catherine M. Turner, and Stephen R. Leeder. "Compliance With Protocols for Prevention of Neonatal Group B Streptococcal Sepsis: Practicalities and Limitations." Infectious Diseases in Obstetrics and Gynecology 11, no. 1 (2003): 1–9. http://dx.doi.org/10.1155/s1064744903000012.

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Objective:To compare two protocols for intrapartum antibiotic prophylaxis (IAP) against neonatal group B streptococcal (GBS) sepsis, with respect to staff compliance, in a prospective cohort study in the obstetric units of a community hospital (A) and a university teaching hospital (B).Methods:Cohorts comprised about 500 women attending antenatal clinics at each hospital (total 1096). Women identified as GBS carriers at 26–32 weeks'gestation and those who had intrapartum clinical risk factors (CRF) were eligible for IAP. Compliance was defined as the proportion of women eligible for IAP who received it according to protocol–as determined by audit of case records–and compared between hospitals and according to indication.Results:Overall, 39% of women were eligible for IAP. Indications were GBS carriage alone (21%), CRF alone (13% ) and both (5% ). Compliance was similar for GBS carriers at both hospitals: 78% at Hospital A and 76% at Hospital B. However, because of the poor predictive value of screening before 32 weeks, only 65%of intrapartum GBS carriers actually received IAP. For women with CRF only, compliance was significantly lower at Hospital B than Hospital A (56 vs. 75%;p= 0.03).Conclusions:According to currently recommended protocols, about one-third of healthy women are eligible for intrapartum antibiotics to prevent neonatal GBS sepsis. In practice, antibiotics are often used inefficiently because of poor compliance with protocols and poor predictive values of selection criteria. Better implementation strategies should improve compliance, but GBS vaccines are needed to replace prophylactic antibiotic use, with its associated disadvantages.

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Fangazio, Margherita, Silvia Melis, Serena Maglione, Gianfranco Sfregola, Michelangelo Barbaglia, Enrico Finale, and Andrea Guala. "Screening della colonizzazione vagino-rettale da streptococco di gruppo B in gravidanza." Medico e Bambino Pagine elettroniche 25, no. 8 (October 31, 2022): 163–67. http://dx.doi.org/10.53126/mebxxvo163.

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Group B beta-haemolytic streptococcus (GBS) is a bacterium that colonizes the genito-intestinal tract of many women and is one of the main causes of neonatal sepsis if screening and antibiotic prophylaxis are not carried out during pregnancy. The best strategy for identifying colonized women (and therefore subjecting them to intrapartum antibiotic prophylaxis) is based on universal cultural screening with the execution of a vagino-rectal swab at 36-37 weeks of gestational age. In 2007, the prevalence of GBS-colonized pregnant women was on average 15.5% in the Piedmont Region (Italy) laboratories that followed the international culture guidelines, while it was 10.5% in the laboratories that did not follow them. In 2010 the Piedmont Regional Health Department carried out an awareness-raising intervention that led to an increase in the average prevalence of GBS (19.2% in 2018), resulting in a net reduction in false negatives. Accurate identification of the carriers to undergo intrapartum prophylaxis makes it possible to prevent the greatest number of early neonatal infections.

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Tambe, Vikas, Versha Shokeen, Himadri Bal, and Ajita Mishra. "A study of the prevalence of group B streptococci in the third trimester of pregnancy." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 8, no. 10 (September 26, 2019): 3911. http://dx.doi.org/10.18203/2320-1770.ijrcog20194353.

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Background: Group B Streptococci (GBS) is an important cause of early onset neonatal sepsis and the maternal colonization of this organism is a key factor in the occurrence of GBS associated morbidity and mortality in the newborns. Timely recognition of its presence in the genital tract of a pregnant women and intrapartum antibiotic prophylaxis can significantly bring down the burden of the disease in neonates. A cross sectional study was conducted on antenatal women during 35-37weeks of gestation to evaluate the prevalence of Group B Streptococci in third trimester of pregnancy and explore the feasibility of including GBS screening in the routine antenatal investigation protocol.Methods: 200 antenatal women satisfying the exclusion/inclusion criteria were recruited for the study. Vaginal and perianal swabs were collected using sterile swab sticks and inoculated using the specified media. Beta hemolysis and typical colonies were looked for under microscope. Positive cases were subjected to intrapartum antibiotic prophylaxis and the neonates were observed for 72 hours to look for any signs of sepsis.Results: It was found that 2% of the women screened were positive for GBS .While none of the newborns of the 4 positive cases showed any signs of sepsis.Conclusions: Prophylactic intrapartum prophylaxis against GBS has shown to decrease the chances of neonatal sepsis but more detailed and robust studies are required before incorporating routine screening in our antenatal care system.

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Dumas, Anne-Marie, Raphaëlle Girard, Louis Ayzac, Geneviève Beaumont, Emmanuelle Caillat-Vallet, Florence Depaix, Chantal Gignoux, et al. "Effect of Intrapartum Antibiotic Prophylaxis Against Group B Streptococcal Infection on Comparisons of Rates of Endometritis and Urinary Tract Infection in Multicenter Surveillance." Infection Control & Hospital Epidemiology 29, no. 4 (April 2008): 327–32. http://dx.doi.org/10.1086/529210.

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Objective.To establish whether antibiotic prophylaxis against group B streptococcal infection may be a confounding factor in comparisons of rates of endometritis and urinary tract infection after vaginal delivery.Design.Prospective study.Setting.Maternity units at 48 hospitals in a regional surveillance network in France during 2001-2004.Methods.The maternity units used a common protocol to establish whether antibiotic prophylaxis was indicated. Risk factors for endometritis and urinary tract infections were evaluated using multiple logistic regression.Results.We analyzed 49,786 vaginal deliveries. The percentage of women receiving antibiotic prophylaxis varied widely and significantly among the maternity units (range, 4.4%-26.0%; median, 15.8%; 25th percentile, 12.1%; 75th percentile, 19.0%) (P < .001, by Mantel-Haenszel χ2 test). The incidence rate of endometritis was significantly reduced from 0.25% to 0.11% by antibiotic prophylaxis (P = .001). There was a decrease in the incidence of urinary tract infection from 0.37% to 0.32%, but it was not statistically significant (P = .251).Conclusions.A reduction in the incidence of endometritis was observed when intrapartum antibiotic prophylaxis against group B streptococcal infection was used. However, the proportion of women considered to be at risk of infection varied widely among institutions. Comparisons of rates of endometritis among maternity units, but not urinary tract infection rates, should take into account antibiotic prophylaxis as a significant confounding factor.

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Antonello, Vicente Sperb, Jessica Dallé, Emilly Dall'Oglio, Suelyn Ramos, Felipe Bassols, and Mirela F. Jimenez. "Alternative antimicrobials for prophylaxis of the Group B Streptococcus maternal-fetal disease." Journal of Infection in Developing Countries 14, no. 06 (June 30, 2020): 664–68. http://dx.doi.org/10.3855/jidc.12180.

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Introduction: GBS colonization is an important risk factor for maternal and neonatal infection morbidity and mortality. Intrapartum antibiotics may prevent vertical transmission of GBS from colonized mothers to their babies. The objective of this study was to evaluate the effectiveness of cefazolin prophylactic regimen for GBS disease, comparing it to the established penicillin-based protocols, given the opportunity provided by the temporary unavailability of first-choice antibiotics in Brazil. Methodology: A retrospective analysis was conducted at the Hospital Femina Obstetrics Service between January and December 2015. Ninety-eight pregnant women received standard penicillin (70 patients) or ampicillin (28 patients) antibiotic prophylaxis, and 251 pregnant women received an alternative prophylaxis with cefazolin during the study period. Risk factor, Maternal and neonatal outcomes were evaluated and compared between groups. Results: No significant difference was found in maternal (RR = 0.71; IC 95%:0.30-1.68; p = 0.709) and neonatal (RR = 0.84; IC 95%:0.61-1.15; p = 0.271) outcomes between those patients using the alternative antibiotic prophylaxis in comparison to the standard antibiotics, with the dependent variable of maternal and neonatal outcomes grouped and controlled for potential confounding variables. Conclusions: The antibiotics used as alternatives to penicillin and ampicillin for the prevention of maternal-fetal GBS disease are poorly studied, and this study indicate that cefazolin can be an optimal choice, offering safety in the use of this antibiotic in situations where penicillins are contraindicated or unavailable.

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Berardi, Alberto, Licia Lugli, Cecilia Rossi, Mariachiara China, Claudio Chiossi, Lucia Gambini, Battista Guidi, et al. "Intrapartum antibiotic prophylaxis failure and group-B streptococcus early-onset disease." Journal of Maternal-Fetal & Neonatal Medicine 24, no. 10 (June 30, 2011): 1221–24. http://dx.doi.org/10.3109/14767058.2011.552652.

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Schrag, Stephanie J., Sara Zywicki, Monica M. Farley, Arthur L. Reingold, Lee H. Harrison, Lewis B. Lefkowitz, James L. Hadler, Richard Danila, Paul R. Cieslak, and Anne Schuchat. "Group B Streptococcal Disease in the Era of Intrapartum Antibiotic Prophylaxis." New England Journal of Medicine 342, no. 1 (January 6, 2000): 15–20. http://dx.doi.org/10.1056/nejm200001063420103.

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Schrag, Stephanie J., Sara Zywicki, Monica M. Farley, Arthur L. Reingold, Lee H. Harrison, Lewis B. Lefkowitz, James L. Hadler, Richard Danila, Paul R. Cieslak, and Anne Schuchat. "Group B Streptococcal Disease in the Era of Intrapartum Antibiotic Prophylaxis." Obstetrical & Gynecological Survey 55, no. 6 (June 2000): 345–46. http://dx.doi.org/10.1097/00006254-200006000-00008.

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Rac, Martha W. F., Laura G. Greer, and George D. Wendel. "Jarisch-Herxheimer Reaction Triggered by Group B Streptococcus Intrapartum Antibiotic Prophylaxis." Obstetrics & Gynecology 116, Supplement (August 2010): 552–56. http://dx.doi.org/10.1097/aog.0b013e3181e7d065.

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O'Connor, Kristine A. "Group B Streptococcal Disease in the Era of Intrapartum Antibiotic Prophylaxis." Clinical Pediatrics 40, no. 6 (June 2001): 361. http://dx.doi.org/10.1177/000992280104000614.

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Levine, E. M., V. Ghai, J. J. Barton, and C. M. Strom. "Intrapartum antibiotic prophylaxis increases the incidence of gram-negative neonatal sepsis." Infectious Diseases in Obstetrics and Gynecology 7, no. 4 (1999): 210–13. http://dx.doi.org/10.1002/(sici)1098-0997(1999)7:4<210::aid-idog10>3.0.co;2-8.

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Janowski, Andrew B., and Jason G. Newland. "From the microbiome to the central nervous system, an update on the epidemiology and pathogenesis of bacterial meningitis in childhood." F1000Research 6 (January 27, 2017): 86. http://dx.doi.org/10.12688/f1000research.8533.1.

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In the past century, advances in antibiotics and vaccination have dramatically altered the incidence and clinical outcomes of bacterial meningitis. We review the shifting epidemiology of meningitis in children, including after the implementation of vaccines that target common meningitic pathogens and the introduction of intrapartum antibiotic prophylaxis offered to mothers colonized withStreptococcus agalactiae. We also discuss what is currently known about the pathogenesis of meningitis. Recent studies of the human microbiome have illustrated dynamic relationships of bacterial and viral populations with the host, which may potentiate the risk of bacterial meningitis.

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Battistin, Fernanda Rieth, Mariana Preussler Mott, Cícero Armídio Gomes Dias, and Vinicius Pietta Perez. "Suscetibilidade antimicrobiana de Streptococcus agalactiae isolados de gestantes em um hospital materno infantil de Porto Alegre, Rio Grande do Sul." Scientia Medica 28, no. 3 (August 3, 2018): 30246. http://dx.doi.org/10.15448/1980-6108.2018.3.30246.

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AIMS: To characterize the antimicrobial susceptibility profile of Streptococcus agalactiae isolated from pregnant women attended at a public hospital.METHODS: The study was carried out in a public maternal and child hospital in Porto Alegre, RS, Brazil, in which the screening for S. agalactiae in pregnant women is part of the obstetrics routine. The study was carried out on anal/vaginal swab tests performed from July 2015 to February 2016. Bacterial isolates were identified by phenotypic tests, and the susceptibility to ampicillin, clindamycin, erythromycin and ofloxacin was determined. The erythromycin resistance genes ermB and mefA were also investigated.RESULTS: A total of 294 samples were included, and of these, 26 (8%) were positive for S. agalactiae. All isolates were susceptible to ampicillin, and resistance to erythromycin (21.4%), clindamycin (14.3%) and ofloxacin (7.1%) were observed. The mefA genotype was observed in 66% of the erythromycin resistant isolates.CONCLUSIONS: Results of this study corroborate the consensus that in pregnant women colonized with S. agalactiae, intrapartum antibiotic prophylaxis with penicillin G or ampicillin is indicated. The relevant proportion of isolates resistant to erythromycin and clindamycin, indicated for intrapartum antibiotic prophylaxis in case of allergy to beta-lactam antibiotics, emphasizes the importance of determining the profile of antimicrobial susceptibility of these isolates, a measure that is not yet part of routine prenatal tests in many institutions.

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Doenhardt, Maren, Barbara Seipolt, Lars Mense, Jennifer Lucia Winkler, Alexander Thürmer, Mario Rüdiger, Reinhard Berner, and Jakob Armann. "Neonatal and young infant sepsis by Group B Streptococci and Escherichia coli: a single-center retrospective analysis in Germany—GBS screening implementation gaps and reduction in antibiotic resistance." European Journal of Pediatrics 179, no. 11 (May 23, 2020): 1769–77. http://dx.doi.org/10.1007/s00431-020-03659-8.

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Abstract The last nationwide surveillance study on neonatal and young infant sepsis due to Group B Streptococci (GBS) and Escherichia coli in Germany was conducted between 2009 and 2010. The aim of this study is to provide longitudinal epidemiological data on neonatal and young infant sepsis caused by GBS and E. coli to reevaluate existing data and to inform clinical decision-making. Every positive blood culture for GBS and E. coli within the first 90 days of life that occurred at our center from 2008 until 2018 was identified. The epidemiological, clinical, laboratory, and microbiological data of all affected patients were analyzed through retrospective chart review, along with the pathogen’s antimicrobial susceptibility results. In total, 106 episodes of neonatal sepsis were described; 31% (n = 33) being caused by GBS and 69% (n = 73) by E. coli; 87% of GBS early-onset disease (EOD) cases did not receive intrapartum antibiotic prophylaxis (IAP). Contrary to general trends, the proportion of resistant E. coli isolates decreased for all tested antibiotics over time. Coincidentally, antenatal antibiotic use beyond IAP during that period decreased significantly in our center. Conclusions: (1) Data at our center suggests at least a regional implementation gap in GBS screening and IAP. (2) The decline in the resistance rate of E. coli for all antimicrobial substances might indicate that the reduction of prenatal antibiotics use is beneficial and that neonatal antibiotic stewardship programs should include pregnant women as well. What is Known:• GBS screening and intrapartum antibiotic prophylaxis led to a 32%-reduction in GBS disease in Germany with a 0.75 (92:122) ratio of early-onset disease to late-onset disease in 2009–2010.• Prenatal antibiotic use might increase the risk of E. coli early-onset disease and antibiotic resistances. What is New:• The GBS early-onset disease rates were twice as high as those of late-onset disease, the ratio was 1.75 (21:12) in 2008–2018 at our institution. This suggests that there are at least regional implementation gaps in the antenatal GBS screening in Germany.• We found a decline in E. coli resistance rates over time for all antimicrobial substances. Reduction in use of prenatal antibiotics might be an explanation.

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Zimmermann, Petra, and Nigel Curtis. "Effect of intrapartum antibiotics on the intestinal microbiota of infants: a systematic review." Archives of Disease in Childhood - Fetal and Neonatal Edition 105, no. 2 (July 11, 2019): 201–8. http://dx.doi.org/10.1136/archdischild-2018-316659.

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IntroductionThe use of intrapartum antibiotic prophylaxis (IAP) has become common practice in obstetric medicine and is used in up to 40% of deliveries. Despite its benefits, the risks associated with exposing large numbers of infants to antibiotics, especially long-term effects on health through changes in the microbiota, remain unclear. This systematic review summarises studies that have investigated the effect of IAP on the intestinal microbiota of infants.MethodsA systematic search in Ovid MEDLINE was used to identify original studies that investigated the effect of IAP on the intestinal microbiota in infants. Studies were excluded if: they included preterm infants, the antibiotic regimen was not specified, antibiotics were used for indications other than prophylaxis, probiotics were given to mothers or infants, or antibiotics were given to infants.ResultsWe identified six studies, which investigated a total of 272 infants and included 502 stool samples collected up to 3 months of age. In all the studies, IAP was given for group B streptococcus (GBS) colonisation. Infants who were exposed to GBS IAP had a lower bacterial diversity, a lower relative abundance of Actinobacteria, especially Bifidobacteriaceae, and a larger relative abundance of Proteobacteria in their intestinal microbiota compared with non-exposed infants. Conflicting results were reported for the phyla Bacteroidetes and Firmicutes.ConclusionsGBS IAP has profound effects on the intestinal microbiota of infants by diminishing beneficial commensals. Such changes during the early-life ‘critical window’ during which the intestinal microbiota and the immune response develop concurrently may have an important influence on immune development. The potential long-term adverse consequences of this on the health of children warrant further investigation.

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Będzichowska, Agata, Karolina Piotrowska-Lis, Paulina Rychcik, Bolesław Kalicki, Agnieszka Rustecka, and Agata Tomaszewska. "Sepsis and Streptococcus agalactiae meningitis in a 3-month-old boy." Pediatria i Medycyna Rodzinna 18, no. 1 (May 31, 2022): 78–83. http://dx.doi.org/10.15557/pimr.2022.0010.

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Streptococcus agalactiae bacteria are a common cause of neonatal sepsis and meningitis. Universal screening of pregnant women for carriage and intrapartum antibiotic prophylaxis has significantly reduced the disease prevalence in children up to 7 days of age. However, it is to be remembered that group B streptococcal infection can also affect older children, even if their mothers have tested negative for Streptococcus agalactiae during pregnancy or underwent complete perinatal antibiotic prophylaxis. This paper presents a clinical case of a 3-month-old boy treated for sepsis and Streptococcus agalactiae meningitis. The baby was born on time, with normal body weight. The infection occurred despite full maternal ampicillin perinatal therapy in the mother.

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Rathore, M. H. "Intrapartum Antibiotic Prophylaxis Effective in Decreasing Early-Onset Group B Streptococcus Infection." AAP Grand Rounds 14, no. 1 (July 1, 2005): 3. http://dx.doi.org/10.1542/gr.14-1-3.

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Bianco, Aida, Elisabetta Larosa, Claudia Pileggi, and Maria Pavia. "Appropriateness of Intrapartum Antibiotic Prophylaxis to Prevent Neonatal Group B Streptococcus Disease." PLOS ONE 11, no. 11 (November 18, 2016): e0166179. http://dx.doi.org/10.1371/journal.pone.0166179.

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Corvaglia, L., E. Legnani, S. Martini, D. Di Gioa, I. Aloisio, M. Oss, B. Biavati, and G. Faldella. "PO47 INTRAPARTUM ANTIBIOTIC PROPHYLAXIS IN MOTHERS GBS-POSITIVE: EFFECTS ON NEWBORN MICROBIOTA." Digestive and Liver Disease 44 (October 2012): S278. http://dx.doi.org/10.1016/s1590-8658(12)60711-7.

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Toyofuku, Meiwa, Miyuki Morozumi, Mariko Hida, Yoshitake Satoh, Hiroshi Sakata, Hiroyuki Shiro, Kimiko Ubukata, Mitsuru Murata, and Satoshi Iwata. "Effects of Intrapartum Antibiotic Prophylaxis on Neonatal Acquisition of Group B Streptococci." Journal of Pediatrics 190 (November 2017): 169–73. http://dx.doi.org/10.1016/j.jpeds.2017.07.039.

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Stark, Mary Ann, Kimberly A. Searing, and Wendy Kershner. "The Perfect Storm: Severe Penicillin Reaction 3 Weeks After Intrapartum Antibiotic Prophylaxis." Journal of Obstetric, Gynecologic & Neonatal Nursing 43 (June 2014): S93—S94. http://dx.doi.org/10.1111/1552-6909.12333.

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Stark, Mary Ann, Mary Frances Ross, Wendy Kershner, and Kimberly Searing. "Case Study of Intrapartum Antibiotic Prophylaxis and Subsequent Postpartum Beta-Lactam Anaphylaxis." Journal of Obstetric, Gynecologic & Neonatal Nursing 44, no. 5 (September 2015): 610–17. http://dx.doi.org/10.1111/1552-6909.12732.

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Desravines, Nerlyne, Kartik Venkatesh, Austin Mitchell Hopkins, Megan Grant, Colleen McGuire, and Kim A. Boggess. "Intrapartum Group B Streptococcus Antibiotic Prophylaxis in Penicillin Allergic Pregnant Women [29L]." Obstetrics & Gynecology 133, no. 1 (May 2019): 136S. http://dx.doi.org/10.1097/01.aog/01.aog.0000559263.94523.55.

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Tonti, Giacomo, Silvia Martini, Luigi Corvaglia, Irene Aloisio, Giuseppe Mazzola, Diana Di Gioia, Bruno Biavati, and Giacomo Faldella. "Development of intestinal flora in breastfed newborns exposed to intrapartum antibiotic prophylaxis." Digestive and Liver Disease 46 (September 2014): e97-e98. http://dx.doi.org/10.1016/j.dld.2014.07.086.

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45

Nienow Birch, Mary N., Alyssa Hersh, Karen Greiner, and Aaron Caughey. "647: The cost effectiveness of GBS screening vs. universal intrapartum antibiotic prophylaxis." American Journal of Obstetrics and Gynecology 220, no. 1 (January 2019): S430. http://dx.doi.org/10.1016/j.ajog.2018.11.669.

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Le Doare, Kirsty, Paul T. Heath, Jane Plumb, Natalie A. Owen, Peter Brocklehurst, and Lucy C. Chappell. "Uncertainties in Screening and Prevention of Group B Streptococcus Disease." Clinical Infectious Diseases 69, no. 4 (December 17, 2018): 720–25. http://dx.doi.org/10.1093/cid/ciy1069.

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Abstract In autumn 2016, the UK Department of Health (now Department of Health and Social Care) convened 2 meetings to discuss how to address research evidence gaps in order to minimize the impact of infant group B streptococcus (GBS) disease in the United Kingdom. At that meeting, a number of research priorities were highlighted, including improving the screening for GBS colonization in pregnant women, offering intrapartum antibiotic prophylaxis and point-of-care testing, and understanding the effect of widespread intrapartum antibiotic use on long-term infant health. Further discussions involved investigating the feasibility of a large prospective study of pregnant women and their infants in order to understand the role of antibodies in the protection against GBS disease in infancy following maternal exposure to GBS colonization. Here, we summarize the research uncertainties identified at that meeting.

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Allen, Upton. "Prevention of perinatal group B streptococcal disease in Canada: An update." Paediatrics & Child Health 2, no. 5 (September 1, 1997): 319–23. http://dx.doi.org/10.1093/pch/2.5.319.

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Abstract Revised guidelines for the prevention of early-onset group B streptococ-cal (GBS) infection were recently issued by the Centers for Disease Control and Prevention (CDC), in conjunction with experts from relevant disciplines. These guidelines have been endorsed by the American College of Obstetricians and Gynecologists and the American Academy of Pediatrics. The CDC recommends one of two prevention strategies. In one strategy, intrapartum antibiotic prophylaxis is offered to women identified as carriers of GBS through prenatal screening at 35 to 37 weeks’ gestation and to women who develop the premature onset of labour or premature rupture of membranes at less than 37 weeks’ gestation. In the other strategy, intrapartum prophylaxis is offered to women who develop one or more risk factors at the onset of labour or membrane rupture. This document summarizes the revised guidelines and compares and contrasts them with the 1994 Canadian consensus guidelines.

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Cheng, Qi, Daniel Nelson, Shiwei Zhu, and Vincent A. Fischetti. "Removal of Group B Streptococci Colonizing the Vagina and Oropharynx of Mice with a Bacteriophage Lytic Enzyme." Antimicrobial Agents and Chemotherapy 49, no. 1 (January 2005): 111–17. http://dx.doi.org/10.1128/aac.49.1.111-117.2005.

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ABSTRACT Group B streptococci (GBS) are the leading cause of neonatal meningitis and sepsis worldwide. The current treatment strategy is limited to intrapartum antibiotic prophylaxis in pregnant women to prevent early-onset neonatal diseases, but considering the potential for antibiotic resistance, the risk of losing control over the disease is high. To approach this problem, we have developed a bacteriophage (phage) lytic enzyme to remove colonizing GBS. Bacteriophage muralytic enzymes, termed lysins, are highly evolved molecules designed to degrade the cell wall of host bacteria to release phage particles from the bacterial cytoplasm. Several different lysins have been developed to specifically kill bacterial pathogens both on mucosal surfaces and in blood and represent a novel approach to control infection. A lysin cloned from a phage infecting GBS was found to contain two putative catalytic domains and one putative binding domain, which is similar to the domain organization of some staphylococcal phage lysins. The lysin (named PlyGBS) was recombinantly expressed in Escherichia coli, and purified PlyGBS efficiently killed all tested GBS serotypes in vitro. In a mouse model, a single dose of PlyGBS significantly reduced bacterial colonization in both the vagina and oropharynx. As an alternative strategy for intrapartum antibiotic prophylaxis, this approach may be used to reduce vaginal GBS colonization in pregnant women before delivery or to decontaminate newborns, thus reducing the incidence of GBS-associated neonatal meningitis and sepsis.

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Berardi, Alberto, Caterina Spada, Eleonora Vaccina, Alessandra Boncompagni, Luca Bedetti, and Laura Lucaccioni. "Intrapartum beta-lactam antibiotics for preventing group B streptococcal early-onset disease: can we abandon the concept of ‘inadequate’ intrapartum antibiotic prophylaxis?" Expert Review of Anti-infective Therapy 18, no. 1 (December 6, 2019): 37–46. http://dx.doi.org/10.1080/14787210.2020.1697233.

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Hegarty, Joanne, Abdul Qader Tahir Ismail, Christos Ioannou, Louise Anthony, Lawrence Impey, and Mark Anthony. "Intrapartum antibiotic prophylaxis for prevention of group B streptococcal disease in preterm infants." Archives of Disease in Childhood - Fetal and Neonatal Edition 98, no. 2 (February 15, 2013): F188. http://dx.doi.org/10.1136/archdischild-2012-303553.

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