FREE NEJM E-TOC    HOME   |   SUBSCRIBE   |   CURRENT ISSUE   |   PAST ISSUES   |   COLLECTIONS   |   Search Term  Advanced Search

Sign in | Get NEJM's E-Mail Table of Contents — Free | Subscribe

Previous Volume 314:1665-1669 June 26, 1986 Number 26 Next

	Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited PubMed Citation

Abstract

Most cases of neonatal group B streptococcal disease with early onset have an intrapartum pathogenesis. Attack rates are increased substantially in infants born to mothers with prenatal group B streptococcal colonization and various perinatal risk factors (premature labor, prolonged membrane rupture, or intrapartum fever). In a randomized controlled trial, we studied the effect of selective intrapartum prophylaxis with ampicillin in 160 such high-risk women. In infants born to mothers who received intravenous ampicillin during labor, as compared with controls who received no treatment, neonatal colonization with group B streptococci was present in 8 of 85 (9 percent) versus 40 of 79 (51 percent; P less than 0.001), colonization at multiple (greater than or equal to 3) sites was observed in 3 of 85 (4 percent) versus 24 of 79 (30 percent; P less than 0.001), and bacteremia occurred in none of 85 versus 5 of 79 (6 percent; P = 0.024). The side effects of ampicillin were limited to a single episode of urticaria in a mother who had no history of penicillin allergy. We conclude that intrapartum ampicillin prophylaxis in women with positive prenatal cultures for group B streptococci who have certain perinatal risk factors can prevent early-onset neonatal group B streptococcal disease.

This article has been cited by other articles:

• Puopolo, K. M. (2008). Epidemiology of Neonatal Early-onset Sepsis. NeoReviews 9: e571-e579 [Abstract] [Full Text]  
• Barber, E. L., Zhao, G., Buhimschi, I. A., Illuzzi, J. L. (2008). Duration of Intrapartum Prophylaxis and Concentration of Penicillin G in Fetal Serum at Delivery. Obstet Gynecol 112: 265-270 [Abstract] [Full Text]  
• Edwards, R. K., Novak-Weekley, S. M., Koty, P. P., Davis, T., Leeds, L. J., Jordan, J. A. (2008). Rapid Group B Streptococci Screening Using a Real-Time Polymerase Chain Reaction Assay. Obstet Gynecol 111: 1335-1341 [Abstract] [Full Text]  
• Carbonell-Estrany, X, Figueras-Aloy, J, Salcedo-Abizanda, S, de la Rosa-Fraile, M, Castrillo Study Group, (2008). Probable early-onset group B streptococcal neonatal sepsis: a serious clinical condition related to intrauterine infection. Arch. Dis. Child. Fetal Neonatal Ed. 93: F85-F89 [Abstract] [Full Text]  
• (2007). Perinatal Group B Streptococcal Disease After Universal Screening Recommendations United States, 2003-2005. JAMA 298: 1390-1392 [Full Text]  
• Trijbels-Smeulders, M, de Jonge, G A, Pasker-de Jong, P C M, Gerards, L J, Adriaanse, A H, van Lingen, R A, Kollee, L A A (2007). Epidemiology of neonatal group B streptococcal disease in the Netherlands before and after introduction of guidelines for prevention. Arch. Dis. Child. Fetal Neonatal Ed. 92: F271-F276 [Abstract] [Full Text]  
• Illuzzi, J. L., Bracken, M. B. (2006). Duration of intrapartum prophylaxis for neonatal group B streptococcal disease: a systematic review.. Obstet Gynecol 108: 1254-1265 [Abstract] [Full Text]  
• Schrag, S. J., Hadler, J. L., Arnold, K. E., Martell-Cleary, P., Reingold, A., Schuchat, A. (2006). Risk Factors for Invasive, Early-Onset Escherichia coli Infections in the Era of Widespread Intrapartum Antibiotic Use. Pediatrics 118: 570-576 [Abstract] [Full Text]  
• Natarajan, G., Johnson, Y. R., Zhang, F., Chen, K. M., Worsham, M. J. (2006). Real-Time Polymerase Chain Reaction for the Rapid Detection of Group B Streptococcal Colonization in Neonates. Pediatrics 118: 14-22 [Abstract] [Full Text]  
• Uhl, J. R., Vetter, E. A., Boldt, K. L., Johnston, B. W., Ramin, K. D., Adams, M. J., Ferrieri, P., Reischl, U., Cockerill, F. R. III (2005). Use of the Roche LightCycler Strep B Assay for Detection of Group B Streptococcus from Vaginal and Rectal Swabs. J. Clin. Microbiol. 43: 4046-4051 [Abstract] [Full Text]  
• Puopolo, K. M., Madoff, L. C., Eichenwald, E. C. (2005). Early-Onset Group B Streptococcal Disease in the Era of Maternal Screening. Pediatrics 115: 1240-1246 [Abstract] [Full Text]  
• Jamie, W. E., Edwards, R. K., Duff, P. (2004). Vaginal-Perianal Compared With Vaginal-Rectal Cultures for Identification of Group B Streptococci. Obstet Gynecol 104: 1058-1061 [Abstract] [Full Text]  
• Gibbs, R. S., Schrag, S., Schuchat, A. (2004). Perinatal Infections Due to Group B Streptococci. Obstet Gynecol 104: 1062-1076 [Abstract] [Full Text]  
• Philip, A. G.S. (2004). Historical perspectives: Group B Streptococcus in Neonatal Sepsis: Emergence as an Important Pathogen. NeoReviews 5: e467-e470 [Full Text]  
• Gilbert, R. (2004). Prenatal screening for group B streptococcal infection: gaps in the evidence. Int J Epidemiol 33: 2-8 [Full Text]  
• Velaphi, S., Siegel, J. D., Wendel, G. D. Jr, Cushion, N., Eid, W. M., Sanchez, P. J. (2003). Early-Onset Group B Streptococcal Infection After a Combined Maternal and Neonatal Group B Streptococcal Chemoprophylaxis Strategy. Pediatrics 111: 541-547 [Abstract] [Full Text]  
• Bartholomew, M. L., Ashkin, E., Schiffman, A., Larsen, J. W. (2002). Maternal Temperature Variation During Parturition. Obstet Gynecol 100: 642-647 [Abstract] [Full Text]  
• Hyde, T. B., Hilger, T. M., Reingold, A., Farley, M. M., O'Brien, K. L., Schuchat, A. (2002). Trends in Incidence and Antimicrobial Resistance of Early-Onset Sepsis: Population-Based Surveillance in San Francisco and Atlanta. Pediatrics 110: 690-695 [Abstract] [Full Text]  
• Edwards, R. K., Clark, P., Sistrom, C. L., Duff, P. (2002). Intrapartum Antibiotic Prophylaxis 1: Relative Effects of Recommended Antibiotics on Gram-Negative Pathogens. Obstet Gynecol 100: 534-539 [Abstract] [Full Text]  
• Edwards, R. K., Clark, P., Duff, P. (2002). Intrapartum Antibiotic Prophylaxis 2: Positive Predictive Value of Antenatal Group B Streptococci Cultures and Antibiotic Susceptibility of Clinical Isolates. Obstet Gynecol 100: 540-544 [Abstract] [Full Text]  
• Haberland, C. A., Benitz, W. E., Sanders, G. D., Pietzsch, J. B., Yamada, S., Nguyen, L., Garber, A. M. (2002). Perinatal Screening for Group B Streptococci: Cost-Benefit Analysis of Rapid Polymerase Chain Reaction. Pediatrics 110: 471-480 [Abstract] [Full Text]  
• Eschenbach, D. A. (2002). Prevention of Neonatal Group B Streptococcal Infection. NEJM 347: 280-281 [Full Text]  
• Orafu, C., Gill, P., Nelson, K., Hecht, B., Hopkins, M. (2002). Perianal Versus Anorectal Specimens: Is There a Difference in Group B Streptococcal Detection?. Obstet Gynecol 99: 1036-1039 [Abstract] [Full Text]  
• (2002). Prevention of group B streptococcal infection in newborns: Recommendation statement from the Canadian Task Force on Preventive Health Care. CMAJ 166: 928-930 [Full Text]  
• Baltimore, R. S., Huie, S. M., Meek, J. I., Schuchat, A., O'Brien, K. L. (2001). Early-Onset Neonatal Sepsis in the Era of Group B Streptococcal Prevention. Pediatrics 108: 1094-1098 [Abstract] [Full Text]  
• Bromberger, P., Lawrence, J. M., Braun, D., Saunders, B., Contreras, R., Petitti, D. B. (2000). The Influence of Intrapartum Antibiotics on the Clinical Spectrum of Early-Onset Group B Streptococcal Infection in Term Infants. Pediatrics 106: 244-250 [Abstract] [Full Text]  
• Turow, J., Spitzer, A. R. (2000). Group B Streptococcal Infection Early Onset Disease Controversies in Prevention Guidelines, and Management Strategies for the Neonate. CLIN PEDIATR 39: 317-326 [Abstract]  
• BROZANSKI, B. S., JONES, J. G., KROHN, M. A., SWEET, R. L. (2000). Effect of a Screening-based Prevention Policy on Prevalence of Early-Onset Group B Streptococcal Sepsis. Obstet Gynecol 95: 496-501 [Abstract] [Full Text]  
• FACTOR, S. H., WHITNEY, C. G., ZYWICKI, S. S., SCHUCHAT, A. (2000). Effects of Hospital Policies Based on 1996 Group B Streptococcal Disease Consensus Guidelines. Obstet Gynecol 95: 377-382 [Abstract] [Full Text]  
• Schrag, S. J., Zywicki, S., Farley, M. M., Reingold, A. L., Harrison, L. H., Lefkowitz, L. B., Hadler, J. L., Danila, R., Cieslak, P. R., Schuchat, A. (2000). Group B Streptococcal Disease in the Era of Intrapartum Antibiotic Prophylaxis. NEJM 342: 15-20 [Abstract] [Full Text]  
• Schuchat, A., Zywicki, S. S., Dinsmoor, M. J., Mercer, B., Romaguera, J., O'Sullivan, M. J., Patel, D., Peters, M. T., Stoll, B., Levine, O. S. (2000). Risk Factors and Opportunities for Prevention of Early-onset Neonatal Sepsis: A Multicenter Case-Control Study. Pediatrics 105: 21-26 [Abstract] [Full Text]  
• Benitz, W. E., Gould, J. B., Druzin, M. L. (1999). Preventing Early-onset Group B Streptococcal Sepsis: Strategy Development Using Decision Analysis. Pediatrics 103: 76e-76 [Abstract] [Full Text]  
• Benitz, W. E., Gould, J. B., Druzin, M. L. (1999). Risk Factors for Early-onset Group B Streptococcal Sepsis: Estimation of Odds Ratios by Critical Literature Review. Pediatrics 103: 77e-77 [Abstract] [Full Text]  
• Benitz, W. E., Gould, J. B., Druzin, M. L. (1999). Antimicrobial Prevention of Early-onset Group B Streptococcal Sepsis: Estimates of Risk Reduction Based on a Critical Literature Review. Pediatrics 103: 78e-78 [Abstract] [Full Text]  
• Mohle-Boetani, J. C., Lieu, T. A., Ray, G. T., Escobar, G., for the Neonatal GBS Prevention Working Group, (1999). Preventing Neonatal Group B Streptococcal Disease: Cost-Effectiveness in a Health Maintenance Organization and the Impact of Delayed Hospital Discharge for Newborns Who Received Intrapartum Antibiotics. Pediatrics 103: 703-710 [Abstract] [Full Text]  
• Baker, C. J., Halsey, N. A., Schuchat, A. (1999). 1997 AAP Guidelines for Prevention of Early-onset Group B Streptococcal Disease. Pediatrics 103: 701-701 [Full Text]  
• Siegel, J. D. (1999). 1997 AAP Guidelines for Prevention of Early-onset Group B Streptococcal Disease. Pediatrics 103: 197-197 [Full Text]  
• ISAACS, D. (1998). Prevention of early onset group B streptococcal infection: screen, treat, or observe?. Arch. Dis. Child. Fetal Neonatal Ed. 79: 81F-82 [Full Text]  
• Stoll, B. J., Holman, R. C., Schuchat, A. (1998). Decline in Sepsis-associated Neonatal and Infant Deaths in the United States, 1979 Through 1994. Pediatrics 102: e18-18 [Abstract] [Full Text]  
• Schuchat, A. (1998). Epidemiology of Group B Streptococcal Disease in the United States: Shifting Paradigms. Clin. Microbiol. Rev. 11: 497-513 [Abstract] [Full Text]  
• Benitz;, W. E., Gotoff, S. P., Boyer, K. M. (1998). The Neonatal Group B Streptococcal Debate. Pediatrics 101: 494-494 [Full Text]  
• Joseph, T. A., Pyati, S. P., Jacobs, N. (1998). Neonatal Early-Onset Escherichia coli Disease: The Effect of Intrapartum Ampicillin. Arch Pediatr Adolesc Med 152: 35-40 [Abstract] [Full Text]  
• Jeffery, H. E., Moses Lahra, M. (1998). Eight-Year Outcome of Universal Screening and Intrapartum Antibiotics for Maternal Group B Streptococcal Carriers. Pediatrics 101 : e2-e2 [Abstract] [Full Text]  
• Allen, S. R. (1997). Management of Asymptomatic Term Neonates Whose Mothers Received Intrapartum Antibiotics Part-1: Rationale for ltrapartum Antibiotic Therapy. CLIN PEDIATR 36: 563-568 [Abstract]  
• Gotoff, S. P., Boyer, K. M. (1997). Prevention of Early-onset Neonatal Group B Streptococcal Disease. Pediatrics 99: 866-866 [Full Text]  
• Johnson, C. E., Whitwell, J. K., Pethe, K., Saxena, K., Super, D. M. (1997). Term Newborns Who Are at Risk for Sepsis: Are Lumbar Punctures Necessary?. Pediatrics 99: e10-e10 [Abstract] [Full Text]  
• Wedgwood, J. F., Carlin, E. B., Benjamin, B. L., Weintraub, A., Lasker, M., Green, R. S., Holzman;, I. R., Schuchat, A., Halsey, N. A. (1997). Penicillin at Birth Can Help Prevent Early-onset Group B Streptococcal Disease. Pediatrics 99: 651-652 [Full Text]  
• Committee on Infectious Diseases and Committee on, (1997). Revised Guidelines for Prevention of Early-onset Group B Streptococcal (GBS) Infection. Pediatrics 99: 489-496 [Abstract] [Full Text]  
• Heimler, R., Nelin, L. D., Billman, D. O., Sasidharan, P. (1995). Identification of Sepsis in Neonates Following Maternal Antibiotic Therapy. CLIN PEDIATR 34: 133-137 [Abstract]