Time to reconsider antibiotic prophylaxis in women with prolonged rupture of membranes: The trend of Enterobacteriaceae in peripartum infections.
Infant, Newborn
Pregnancy
Female
Humans
Antibiotic Prophylaxis
Enterobacteriaceae
Retrospective Studies
Fetal Membranes, Premature Rupture
/ epidemiology
Peripartum Period
Streptococcal Infections
/ microbiology
Anti-Bacterial Agents
/ therapeutic use
Ampicillin
/ therapeutic use
Bacteremia
/ epidemiology
Streptococcus agalactiae
Enterobacteriaceae
ampicillin-resistant
birth cultures
chorioamnionitis
early-onset sepsis
endometritis
peripartum fever
prolonged rupture of membranes
Journal
International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics
ISSN: 1879-3479
Titre abrégé: Int J Gynaecol Obstet
Pays: United States
ID NLM: 0210174
Informations de publication
Date de publication:
Dec 2023
Dec 2023
Historique:
revised:
11
05
2023
received:
21
02
2023
accepted:
16
05
2023
medline:
15
11
2023
pubmed:
6
6
2023
entrez:
6
6
2023
Statut:
ppublish
Résumé
The proportion of neonatal early-onset sepsis (EOS) by gram-negative bacteria has increased. The authors examined bacterial distribution in the amniotic membrane cultures of women with peripartum fever (PPF) and related perinatal outcomes. This retrospective study covered the period 2011 to 2019. The primary outcomes were Enterobacteriaceae-positive birth culture rates in women with PPF and the trend of ampicillin resistance. Maternal and neonatal outcomes were compared between women with group B Streptococcus (GBS) and Enterobacteriaceae-positive isolates. Bacterial distribution was also compared according to rupture of membrane (ROM) duration. Among 621 women with PPF, the positive birth culture rate was 52%. Increasing prevalences of ampicillin-resistant Enterobacteriaceae (81%) were noted. Positive birth cultures were associated with maternal bacteremia (P = 0.017) and neonatal EOS (P = 0.003). Prolonged ROM ≥18 h was associated with increased risk for Enterobacteriaceae-positive cultures, while intrapartum ampicillin and gentamicin were associated with lower risk. Enterobacteriaceae-positive compared with GBS-positive birth cultures were associated with adverse maternal and neonatal outcomes. Positive birth cultures were related to maternal bacteremia and neonatal sepsis. Adverse outcomes were more prevalent among women with Enterobacteriaceae-positive versus GBS-positive birth cultures. Prolonged ROM is a risk factor for Enterobacteriaceae-positive birth cultures among women with PPF. Antibiotic prophylaxis treatment for prolonged ROM should be reconsidered.
Substances chimiques
Anti-Bacterial Agents
0
Ampicillin
7C782967RD
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
956-964Informations de copyright
© 2023 International Federation of Gynecology and Obstetrics.
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