Abstract:Objective To investigate the effect of prenatal antibiotic treatment on neonates whose mothers tested positive with streptococcus lactis in the third trimester of pregnancy and the related indexes of septicemia detection in high-risk newborns.Methods A total of 105 high-risk newborns born to pregnant women with positive GBS screening in the neonatal ward of the Fifth Medical Center of the PLA General Hospital were selected between January 2017 and December 2019. According to whether prenatal intravenous antibiotics were used, these newborns were divided into the antibiotic group (n=45) and control group (n=60) 2 ml venous blood was collected from each newborn in the two groups for routine blood detection at 6, 24, 72 h after birth and for PCT detection at 72 h after birth. After admission, newborns whose levels of leukocytes or CRP tested abnormal for the first time were treated with penicillin. Blood culture tests were completed prior to antibiotic use.Results There was no significant difference in the white blood cell count at 6, 24 and 72 hours after birth between the two groups. Levels of CRP measured at 24 and 72 hours after birth were higher in the control group than in the antibiotic group (P<0.05). There was no difference in levels of PCT measured 72 hours after birth between the two groups. In the control group, there were 2 cases of neonatal septicaemia (GBS was detected in blood culture) and 7 cases of clinically diagnosed septicaemia. In the antibiotic group, there was one case of streptococcus agalactiae septicaemia (GBS was detected in blood culture). The incidence of sepsis in the control group was significantly higher than that of the antibiotic group [2.2% vs.15.0%,χ2=4.872,P=0.027].Conclusions If pregnant women with positive GBS screening receive no antibiotic treatment before delivery, the chance of neonatal septicemia is significantly increased. CRP can be used as an indicator of sepsis in high-risk neonates born to pregnant women with positive GBS screening in the third trimester.
Kwatra G,Cunnington M C,Merrall E, et al. Prevalence of maternal colonisation with group B streptococcus:a systematic review and meta-analysis[J]. Lancet Infect Dis, 2016, 16(9):1076-1084.
Schrag S J, Verani J R. Intrapartum antibiotic prophylaxis for the prevention of perinatal group B streptococcal disease: exexperience in the United States and implycations for a potential group B streptococcal vaccine[J].Vaccine, 2013, 31(4): D20-D26.
Le D K, Heath P T. An overview of global GBS epidemiology[J].Vaccine,2013,31(suppl 4): D7-D12.
[13]
Lu B, Li D, Cui Y, et al. Epidemiology of Group B streptococcus isolated from pregnant women in beijing,China[J]. Clin Microbiol Infect, 2014, 20(6): 370-373.
Phares C R, Lynfield R, Farley M M, et al. Epidemiology of invasive group B streptococcal disease in the United States, 1999-2005. Active bacterial core surveillance/emerging infections programnetwork[J]. JAMA, 2008, 299(20):56-65.