scholarly journals Impact of Intrapartum Antibiotic Prophylaxis on Offspring Microbiota

2021 ◽  
Vol 9 ◽  
Author(s):  
S. Prescott ◽  
C. Dreisbach ◽  
K. Baumgartel ◽  
R. Koerner ◽  
A. Gyamfi ◽  
...  
Keyword(s):  
Antibiotic Prophylaxis ◽  
Neonatal Infection ◽  
Antibiotic Use ◽  
Microbial Colonization ◽  
Antibiotic Administration ◽  
Intrapartum Antibiotic Prophylaxis ◽  
Early Onset Sepsis ◽  
Colonization Process ◽  
Intrapartum Antibiotic ◽  
The Impact

Infants are born into a world filled with microbes and must adapt without undue immune response while exploiting the microbiota's ability to produce otherwise unavailable nutrients. The process by which humans and microbes establish this relationship has only recently begun to be studied with the aid of genomic methods. Nearly half of all pregnant women receive antibiotics during gestation to prevent maternal and neonatal infection. Though this has been largely successful in reducing early-onset sepsis, we have yet to understand the long-term consequences of antibiotic administration during gestation to developing infants. Studies involving antibiotic use in infants suggest that dysbiosis during this period is associated with increased obesity, allergy, autoimmunity, and chronic diseases in adulthood, however, research around the limited doses of intravenous antibiotics used for intrapartum prophylaxis is limited. In this mini review, we focused on the state of the science regarding the effects of intrapartum antibiotic prophylaxis on the newborn microbial colonization process. Although, the literature indicates that there is wide variety in the specific bacteria that colonize infants from birth, limited parenteral antibiotic administration prior to delivery consistently affects the microbiota of infants by decreasing bacteria in the phylum Bacteroidetes and increasing bacteria in the phylum Proteobacteria, thus altering the normal pattern of colonization that infants experience. Delivery by cesarean section and formula feeding magnify and prolong this effect. Our mini review shows that the impact of intravenous antibiotic administration during gestation has on early colonization, growth, or immune programming in the developing offspring has not been well studied in human or animal models.

scholarly journals Need for Intrapartum Antibiotic Prophylaxis in Women with Prior History of Group B Streptococcus Carriage

2021 ◽  
Vol 5 (2) ◽  
Keyword(s):  
Antibiotic Prophylaxis ◽  
Point Of Care ◽  
Neonatal Infection ◽  
University Hospital ◽  
Prior History ◽  
Point Of Care Testing ◽  
Benzyl Penicillin ◽  
Intrapartum Antibiotic Prophylaxis ◽  
History Of ◽  
Intrapartum Antibiotic

The incidence of early onset neonatal GBS(EOGBS) disease in the UK and Ireland is 0.57/1000 births. Intrapartum antibiotic prophylaxis (IAP) reduces the risk. Previous colonisation is associated with 50% carriage in the current pregnancy. In these women, RCOG recommends IAP with a history of neonatal infection, otherwise offering the option of screening at 35-37 weeks. In Ireland, there is no national consensus on IAP in prior GBS colonisation. Currently at University Hospital Waterford (UHW), all women with prior GBS colonisation receive IAP. Studies examining the use of point-of-care testing have shown reduction in the use of IAP and EOGBS rates. We aimed to examine the screening and IAP administration in maternal prior GBS colonisation and the incidence of GBS in this cohort in UHW. Data was collected retrospectively from laboratory, medical records and electronic patient manager systems. Women who received IAP between 1stJuly 2020 and 31stDecember 2020 were identified. Women who received IAP for current and prior GBS colonisation were included. Women who received IAP for preterm labour, preterm prelabour rupture of membranes and pyrexia in labour were excluded. Ninety-two women with current or prior GBS colonisation received IAP, of which only 15(16.30%) were current and 77(83.69%) were prior GBS colonisation. In women with prior GBS colonisation, 49(63.63%) were screened, 3/49(6.12%) were positive, 28 were not screened. Seventy-eight (84.78%) received benzyl-penicillin. Six (6.52%) received clindamycin. Twenty-two (23.91%) babies were admitted to the Neonatal Unit, however, only one cultured positive for gram-positive cocci. The incidence of EOGBS in this cohort is low. A risk-based approach or point-of-care testing should be considered to reduce unnecessary IAP administration.

scholarly journals Intrapartum Antibiotic Prophylaxis and Early-Onset Neonatal Sepsis Patterns

2003 ◽  
Vol 11 (4) ◽  
pp. 221-226 ◽  
Author(s):  
Rodney K. Edwards ◽  
Whitney E. Jamie ◽  
Donald Sterner ◽  
Susan Gentry ◽  
Kathy Counts ◽  
...  
Keyword(s):  
Antibiotic Prophylaxis ◽  
Neonatal Sepsis ◽  
Early Onset ◽  
Intrapartum Antibiotic Prophylaxis ◽  
Intrapartum Antibiotic

Vaginal group B streptococcus status during intrapartum antibiotic prophylaxis

2014 ◽  
Vol 129 (1) ◽  
pp. 9-12 ◽  
Author(s):  
Santiago Scasso ◽  
Joel Laufer ◽  
Grisel Rodriguez ◽  
Justo G. Alonso ◽  
Claudio G. Sosa
Keyword(s):  
Antibiotic Prophylaxis ◽  
Group B Streptococcus ◽  
Intrapartum Antibiotic Prophylaxis ◽  
Intrapartum Antibiotic ◽  
Group B

scholarly journals Removal of Group B Streptococci Colonizing the Vagina and Oropharynx of Mice with a Bacteriophage Lytic Enzyme

2005 ◽  
Vol 49 (1) ◽  
pp. 111-117 ◽  
Author(s):  
Qi Cheng ◽  
Daniel Nelson ◽  
Shiwei Zhu ◽  
Vincent A. Fischetti
Keyword(s):  
Antibiotic Prophylaxis ◽  
Pregnant Women ◽  
Bacterial Colonization ◽  
Lytic Enzyme ◽  
Neonatal Meningitis ◽  
Group B Streptococci ◽  
Intrapartum Antibiotic Prophylaxis ◽  
Intrapartum Antibiotic ◽  
Group B

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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