School of Medicine, Division of Neonatal-Perinatal Medicine, University of North Carolina, Chapel Hill, NC, USA.
Pediatr Infect Dis J. 2013 Mar;32(3):208-12. doi: 10.1097/INF.0b013e318275058a.
Group B Streptococcus (GBS) and Escherichia coli cause serious bacterial infections (SBIs) and are associated with morbidity and mortality in newborn infants. Intrapartum antibiotic prophylaxis reduces early-onset SBIs caused by GBS. The effect of intrapartum antibiotic prophylaxis on late-onset SBIs caused by these organisms is unknown.
We examined all blood, urine and cerebrospinal fluid culture results from infants admitted from 1997 to 2010 to 322 neonatal intensive care units managed by the Pediatrix Medical Group. We identified infants with positive cultures for GBS or E. coli and compared the incidence of early- and late-onset SBI for each organism in the time period before (1997 to 2001) and after (2002 to 2010) universal intrapartum antibiotic prophylaxis recommendations.
We identified 716,407 infants with cultures, 2520 (0.4%) with cultures positive for GBS and 2476 (0.3%) with cultures positive for E. coli. The incidence of GBS early-onset SBI decreased between 1997 to 2001 and 2002 to 2010 from 3.5 to 2.6 per 1000 admissions, and the incidence for E. coli early-onset SBI remained stable (1.4/1000 admissions in both time periods). Over the same time period, the incidence of GBS late-onset SBI increased from 0.8 to 1.1 per 1000 admissions, and incidence of E. coli late-onset SBI increased from 2.2 to 2.5 per 1000 admissions.
In our cohort, the incidence of GBS early-onset SBI decreased, whereas the incidence of late-onset SBI for E. coli and GBS increased.
B 型链球菌（GBS）和大肠杆菌可引起严重的细菌感染（SBIs），并与新生儿的发病率和死亡率有关。分娩时抗生素预防可减少由 GBS 引起的早发性 SBIs。分娩时抗生素预防对这些病原体引起的晚发性 SBIs 的影响尚不清楚。
我们检查了 1997 年至 2010 年期间，由 Pediatrix 医疗集团管理的 322 个新生儿重症监护病房收治的所有婴儿的血液、尿液和脑脊液培养结果。我们确定了 GBS 或大肠杆菌培养阳性的婴儿，并比较了在普遍使用分娩时抗生素预防建议之前（1997 年至 2001 年）和之后（2002 年至 2010 年）每个时期每种病原体的早发性和晚发性 SBI 的发生率。
我们共确定了 716407 例有培养结果的婴儿，2520 例（0.4%）培养出 GBS，2476 例（0.3%）培养出大肠杆菌。1997 年至 2001 年和 2002 年至 2010 年，GBS 早发性 SBI 的发生率从每 1000 例入院 3.5 例降至 2.6 例，而大肠杆菌早发性 SBI 的发生率保持稳定（两个时期均为每 1000 例入院 1.4 例）。在同一时期，GBS 晚发性 SBI 的发生率从每 1000 例入院 0.8 例增加到 1.1 例，而大肠杆菌晚发性 SBI 的发生率从每 1000 例入院 2.2 例增加到 2.5 例。
在我们的队列中，GBS 早发性 SBI 的发生率下降，而大肠杆菌和 GBS 晚发性 SBI 的发生率增加。
