Does Maternal Intrapartum Antibiotic Treatment Prolong the Incubation Time Required for Blood Cultures to Become Positive for Infants with Early-Onset Sepsis?

Siddhartha Sean Sarkar; Indira Bhagat; Varsha Bhatt-Mehta; Subrata Sarkar

doi:10.1055/s-0034-1387933

American Journal of Perinatology, Inhaltsverzeichnis

Am J Perinatol 2015; 32(04): 357-362
DOI: 10.1055/s-0034-1387933

Original Article

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Does Maternal Intrapartum Antibiotic Treatment Prolong the Incubation Time Required for Blood Cultures to Become Positive for Infants with Early-Onset Sepsis?

Siddhartha Sean Sarkar

¹Division of Neonatal-Perinatal Medicine, Department of Pediatrics and Communicable Diseases, C.S. Mott Children's Hospital, University of Michigan, Ann Arbor, Michigan

,

Indira Bhagat

²Department of Pediatrics, University of Wisconsin Hospitals and Clinics, Madison, Wisconsin

,

Varsha Bhatt-Mehta

³Pharmacy, Pediatrics and Communicable Diseases, C.S. Mott Children's Hospital, University of Michigan, Ann Arbor, Michigan

,

Subrata Sarkar

¹Division of Neonatal-Perinatal Medicine, Department of Pediatrics and Communicable Diseases, C.S. Mott Children's Hospital, University of Michigan, Ann Arbor, Michigan

› Institutsangaben

Abstract

Background We hypothesized that maternal intrapartum antibiotic treatment delays the growth of the organism in the blood culture obtained during the work-up for infants with suspected early-onset sepsis (EOS).

Methods Single center, retrospective review of infants with blood culture–proven EOS over 13.5 years period. EOS was defined by isolation of a pathogen from blood culture obtained within 72 hours of birth and antibiotic treatment for ≥ 5 days.

Results Among 81 infants with positive blood cultures, 38 were deemed to have EOS and 43 were deemed contaminants. The organisms grown were as follows: Escherichia coli in 17 infants, Group B streptococcus in 10 infants, and others in 11 infants. Overall, 17 infants with EOS did not receive intrapartum antibiotics and had blood cultures drawn for being symptomatic after birth. The other 21 infants who received intrapartum antibiotics had blood culture drawn primarily for maternal chorioamnionitis. The median (interquartile range [IQR]) incubation time to blood culture positivity was not different in infants who received intrapartum antibiotics compared with infants who did not (19.6 hours, IQR 16–28 hours vs. 19.5 hours, IQR 17.2–21.6 hours, p = 0.7489).

Conclusion Maternal intrapartum antibiotic treatment did not delay the time to blood culture positivity in infants with EOS.

Keywords

intrapartum chemoprophylaxis - early-onset neonatal sepsis - time to blood culture positivity

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Referenzen

References
1 Stoll BJ, Hansen NI, Sánchez PJ , et al; Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network. Early onset neonatal sepsis: the burden of group B Streptococcal and E. coli disease continues. Pediatrics 2011; 127 (5) 817-826
2 Polin R, Parravicini E, Regan J, Taeusch H. Bacterial sepsis and meningitis. In: Taeusch W, Ballard RA, Gleason CA, , eds. Avery's Diseases of the Newborn, 8th ed. Philadelphia, PA: WB Saunders; 2005: 551-557
3 Levi MH, Gialanella P, Motyl MR, McKitrick JC. Rapid detection of positive blood cultures with the BACTEC NR-660 does not require first-day subculturing. J Clin Microbiol 1988; 26 (11) 2262-2265
4 Jardine L, Davies MW, Faoagali J. Incubation time required for neonatal blood cultures to become positive. J Paediatr Child Health 2006; 42 (12) 797-802
5 Neal PR, Kleiman MB, Reynolds JK, Allen SD, Lemons JA, Yu PL. Volume of blood submitted for culture from neonates. J Clin Microbiol 1986; 24 (3) 353-356
6 Schelonka RL, Chai MK, Yoder BA, Hensley D, Brockett RM, Ascher DP. Volume of blood required to detect common neonatal pathogens. J Pediatr 1996; 129 (2) 275-278
7 Washington II JA, Ilstrup DM. Blood cultures: issues and controversies. Rev Infect Dis 1986; 8 (5) 792-802
8 Verani JR, McGee L, Schrag SJ ; Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC). Prevention of perinatal group B streptococcal disease—revised guidelines from CDC, 2010. MMWR Recomm Rep 2010; 59 (RR-10): 1-36
9 Schrag S, Gorwitz R, Fultz-Butts K, Schuchat A. Prevention of perinatal group B streptococcal disease. Revised guidelines from CDC. MMWR Recomm Rep 2002; 51 (RR-11): 1-22
10 Bizzarro MJ, Dembry L-M, Baltimore RS, Gallagher PG. Changing patterns in neonatal Escherichia coli sepsis and ampicillin resistance in the era of intrapartum antibiotic prophylaxis. Pediatrics 2008; 121 (4) 689-696
11 Stoll BJ, Hansen N, Fanaroff AA , et al. Changes in pathogens causing early-onset sepsis in very-low-birth-weight infants. N Engl J Med 2002; 347 (4) 240-247
12 Joseph TA, Pyati SP, Jacobs N. Neonatal early-onset Escherichia coli disease. The effect of intrapartum ampicillin. Arch Pediatr Adolesc Med 1998; 152 (1) 35-40
13 Towers CV, Carr M, Padilla G , et al. Potential consequences of widespread antepartal use of ampicillin. Am J Obstet Gynecol 1998; 179 (4) 879-883
14 Blackburn RM, Muller-Pebody B, Planche T , et al. Neonatal sepsis—many blood samples, few positive cultures: implications for improving antibiotic prescribing. Arch Dis Child Fetal Neonatal Ed 2012; 97 (6) F487-F488