scholarly journals Evaluation of Cefotaxime and Desacetylcefotaxime Concentrations in Cord Blood after Intrapartum Prophylaxis with Cefotaxime

2009 ◽  
Vol 53 (6) ◽  
pp. 2342-2345 ◽  
Author(s):  
Jacques Lepercq ◽  
Jean Marc Treluyer ◽  
Christelle Auger ◽  
Josette Raymond ◽  
Elisabeth Rey ◽  
...  
Keyword(s):  
Cord Blood ◽  
Neonatal Sepsis ◽  
Premature Rupture ◽  
Group B Streptococci ◽  
E Coli ◽  
Preterm Premature Rupture ◽  
The Family ◽  
Early Neonatal Sepsis ◽  
Blood Specimens ◽  
Group B

ABSTRACT Preterm premature rupture of the membranes is associated with a high risk of neonatal sepsis. An increase in the incidence of early-onset neonatal sepsis due to ampicillin-resistant Escherichia coli in premature infants has been observed in the past few years. Intrapartum prophylaxis with ampicillin has proven to be efficient for the prevention of early neonatal sepsis due to group B streptococci. To date, there is no strategy for the prevention of early neonatal sepsis due to ampicillin-resistant E. coli. Our aim was to investigate whether a standardized dosage regimen of intrapartum cefotaxime could provide concentrations in the cord blood greater than the cefotaxime MIC90 for E. coli. Seven pregnant women hospitalized with preterm premature rupture of the membranes and colonized with ampicillin-resistant isolates of the family Enterobacteriaceae were included. Cefotaxime was given intravenously during delivery, as follows: 2 g at the onset of labor and then 1 g every 4 h until delivery. Blood specimens were collected from the mother 30 min after the first injection and just before the second injection, and at birth, blood specimens were simultaneously collected from the mother and the umbilical cord. The concentrations of cefotaxime in the cord blood ranged from 0.5 to 8.5 mg/liter. The MIC90 of cefotaxime for E. coli strains (0.125 mg/liter) was achieved in all cases. This preliminary study supports the use of cefotaxime for intrapartum prophylaxis in women colonized with ampicillin-resistant isolates of Enterobacteriaceae. The effectiveness of this regimen for the prevention of neonatal sepsis needs to be evaluated with a larger population.

scholarly journals Identification of causative pathogen and its antibiotic sensitivity in cases of preterm premature rupture of membranes

2019 ◽  
Vol 8 (11) ◽  
pp. 4250
Author(s):  
Sai Prasanna Kandukuri ◽  
Ramamani Chadalawada ◽  
Bhavishya Gollapalli
Keyword(s):  
Gardnerella Vaginalis ◽  
Diffusion Method ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Group B Streptococci ◽  
Disk Diffusion Method ◽  
Membrane Rupture ◽  
Preterm Premature Rupture ◽  
Vaginal Swabs ◽  
Group B

Background: Pre-labor rupture of membranes is defined as amniotic membrane rupture before the onset of labor contractions, and if it happens before 37 weeks, it is called preterm premature rupture of membranes (PPROM). Several organisms commonly present in the vaginal tract are E.coli, Group-B streptococci, staphylococcus aureus, chlamydia trachomatis, Gardnerella vaginalis and Enterococcus faecalis which secrete proteases that degrade collagen thereby weakening  the fetal membranes leading to PPROM. Appropriate antibiotic therapy has a significant role in the prevention and treatment of maternal and neonatal complications.Methods: This was a prospective observational study done in the department of obstetrics and gynaecology, Narayana medical college, Nellore. Selectively 100 patients with complaint of PPROM admitted to labor room were included in the study. Diagnosis of membrane rupture was established by speculum examination, and high vaginal swabs are taken and sent to laboratory for identifying bacteria using gram staining and cultured in aerobic and anaerobic methods. Antimicrobial susceptibility testing of the organisms was performed by disk diffusion method by Kirby and Bauer.Results: Out of 100, high vaginal swabs had growth in 82 patients, and 18 were sterile. The repeatedly isolated organism in patients with PPROM is E.coli amounting 32%, followed by candidal species 20%. Staphylococci are scoring 11% and enterococci 8%. However, organisms like gardenella vaginalis and Group B streptococcus are least common with a score of 6% and 5% respectively. In this study, E.coli is highly sensitive to tigecycline, colistin 100% each and highly resistant to gentamycin and amikacin.Conclusions: In this study, E.coli is related to the maximum number of cases with preterm premature rupture of membranes. Appropriate use of antibiotics significantly lowers maternal morbidity and neonatal mortality.

scholarly journals Meconium in the Amniotic Fluid of Pregnancies Complicated by Preterm Premature Rupture of Membranes Is Associated With Early Onset Neonatal Sepsis

1995 ◽  
Vol 3 (1) ◽  
pp. 22-27 ◽  
Author(s):  
Michael J. Kupferminc ◽  
Elizabeth Wickstrom ◽  
Nam H. Cho ◽  
Patricia M. Garcia
Keyword(s):  
Amniotic Fluid ◽  
Neonatal Sepsis ◽  
Early Onset ◽  
Multiple Logistic Regression Analysis ◽  
Study Group ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Preterm Premature Rupture ◽  
Group B ◽  
Heart Rate Pattern

Objective: This study was to determine the significance of meconium in the amniotic fluid of pregnancies complicated by preterm premature rupture of membranes (PPROM) without labor.Methods: A case-control study of 31 pregnancies complicated by PPROM at 27–36 weeks gestation with meconium present (study group) and 93 pregnancies complicated by PPROM but without meconium was performed. The patients were matched for year of delivery, gestational age, race, and parity. Pregnancy and neonatal outcome variables of the 2 groups were compared.Results: The incidence of early onset neonatal sepsis was significantly increased in the study group (16.1% vs. 1.1%; P < 0.001). Similarly, chorioamnionitis (48.3% vs. 22.5%; P < 0.01), cesarean delivery for a nonreassuring fetal heart rate pattern (19.4% vs. 3.2%; P < 0.01), a 5-min Apgar score < 7 (22.5% vs. 8.6%; P < 0.05), and fetal growth retardation (FGR) (12.9% vs. 2.2%; P < 0.05) were also more common in pregnancies complicated by PPROM with meconium. The mean umbilical cord arterial pH was significantly lower in these pregnancies (7.18 ± 0.07 vs. 7.28 ± 0.08; P < 0.001). After controlling for confounding variables with multiple logistic regression analysis, we found that meconium in the amniotic fluid remained associated with early onset neonatal sepsis.Conclusions: The presence of meconium in the amniotic fluid of pregnancies complicated by PPROM is associated with an increased incidence of early onset neonatal group B β-hemolytic streptococcus (GBBS) sepsis.

scholarly journals Pregnancy outcome in preterm premature rupture of membranes between 24 to 34 weeks of gestation

2020 ◽  
Vol 9 (12) ◽  
pp. 5043
Author(s):  
Sujatha Venkatraman ◽  
Latha Chaturvedula ◽  
Subhash Chandra Parija
Keyword(s):  
Respiratory Distress ◽  
Neonatal Intensive Care ◽  
Latency Period ◽  
Primary Objective ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Group B Streptococci ◽  
Preterm Premature Rupture ◽  
Nicu Admission ◽  
Group B

Background: Preterm premature rupture of membranes (PPROM) is spontaneous rupture of the fetal membranes before 37 completed weeks and before onset of labour which complicates 3-5% of all pregnancies. Studies regarding PPROM in very early gestation are lacking. The primary objective was to assess the maternal and perinatal outcome in preterm premature rupture of membranes and secondary objective was to assess the colonization of group B Streptococci (GBS) and Listeria monocytogenes in patients with PPROM.Methods: This prospective study was performed on 175 antenatal women with PPROM between 24 to 34 weeks of gestation.Results: Majority of women (54.2%) were between 32 to 34 weeks of gestation, 37% were between 28 to 32 weeks of gestation and 7.8% were between 24 to 28 weeks of gestation. About 22 % of women had cervicovaginal infections. The prevalence of group B Streptococci in the study group was 1.2% and no isolates of Listeria. The most common maternal morbidity was puerperal fever (11.4 %). Among newborn babies 87 (55 %) required neonatal intensive care unit (NICU) admission mainly for respiratory distress and prematurity. With each week of increase in gestational age, there is decrease in latency period by 22 hours and duration of NICU stay nearly by one day.Conclusions: From the present study it may be concluded that PPROM is associated with genitourinary infection, puerperal pyrexia and respiratory distress syndrome among neonates. The prevalence of group B Streptococci in antenatal women with PPROM is very low and no Listeria were isolated.

scholarly journals 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

2020 ◽  
Vol 179 (11) ◽  
pp. 1769-1777
Author(s):  
Maren Doenhardt ◽  
Barbara Seipolt ◽  
Lars Mense ◽  
Jennifer Lucia Winkler ◽  
Alexander Thürmer ◽  
...  
Keyword(s):  
Early Onset ◽  
Late Onset ◽  
Young Infant ◽  
Antibiotic Use ◽  
Group B Streptococci ◽  
E Coli ◽  
Antimicrobial Substances ◽  
Intrapartum Antibiotic ◽  
Group B ◽  
Implementation Gaps

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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