Skip to main navigation menu Skip to main content Skip to site footer
##common.pageHeaderLogo.altText##

Review article: Biomedical intelligence

Vol. 143 No. 3738 (2013)

Recommendations for term and late preterm infants at risk for perinatal bacterial infection

  • Martin Stocker
  • Christoph Berger
  • Jane McDougall
  • Eric Giannoni
DOI
https://doi.org/10.4414/smw.2013.13873
Cite this as:
Swiss Med Wkly. 2013;143:w13873
Published
08.09.2013

Summary

Since publication of the initial guidelines for the prevention of group B streptococcal disease in 1996, the incidence of perinatal infection has decreased significantly. Intrapartum antibiotic prophylaxis together with appropriate management of neonates at increased risk for early-onset sepsis not only reduces morbidity and mortality, but also decreases the burden of unnecessary or prolonged antibiotic therapy. This article provides healthcare workers in Switzerland with evidence-based and best-practice derived guidelines for the assessment and management of term and late preterm infants (>34 weeks) at increased risk for perinatal bacterial infection. Management of neonates at increased risk for early-onset sepsis depends on clinical presentation and risk factors. Asymptomatic infants with risk factors for early-onset sepsis should be observed closely in an inpatient setting for the first 48 hours of life. Symptomatic neonates must be treated promptly with intravenous antibiotics. As clinical and laboratory signs of neonatal infection are nonspecific, it is mandatory to reevaluate the need for continued antibiotic therapy after 48 hours.

References

  1. Berger C, Giannoni E, McDougall J, Stocker M. Empfehlung zur Prävention von Termin- und knapp frühgeborenen Kindern (>34 SSW) mit erhöhtem Risiko einer perinatalen bakteriellen Infektion (early-onset Sepsis). Paediatrica. 2013;24:12–5.
  2. Centers for Disease Control and Prevention. Prevention of perinatal group B streptococcal disease. MMWR. 2010;59:1–32.
  3. Weston EJ, Pondo T, Lewis MM, et al. The Burden of invasive early-onset neonatal sepsis in the United States, 2005–2008. Pediatr Infect Dis J. 2011;30:937–41.
  4. Kenyon S, Boulvain M, Neilson JP. Antibiotics for preterm rupture of membranes. Cochrane Database Syst Rev. 2010;(8):CD001058
  5. Vergnano S, Menson E, Kennea N, et al. Neonatal infections in England: the NeonIN surveillance network. Arch Dis Child Fetal Neonatal Ed. 2011;96:F9–F14.
  6. Daley AJ, Isaacs D, Australian Study Group for Neonatal Infections. Ten-year study on the effect of intrapartum antibiotic prophylaxis on early onset group B streptococcal and Escherichia coli neonatal sepsis in Australasia. Pediatr Infect Dis J. 2004;23:630–4.
  7. Policy Statement of the American Academy of Pediatrics. Recommendations for the prevention of perinatal group B Streptococcal (GBS) disease. Pediatrics. 2011,128:611–6.
  8. Clinical report of the American Academy of Pediatrics. Management of neonates with suspected of proven early-onset bacterial sepsis. Pediatrics. 2012;129:1006–15.
  9. Clifford V, Garland SM, Grimwood K. Prevention of neonatal group B Streptococcus disease in the 21st century. J Paed Child Health. 2012;48:808–15.
  10. National Institute for Health and Clinical Excellence: Antibiotics for early-onset neonatal infection. NICE clinical guideline 149, 2012. http://www.guidance.nice.org.uk/ cg149: assessed Mai 2013.
  11. Capanna F, Emonet SP, Cherkaout A, Irion O, Schrenzel J, Martinez de Tejada B. Antibiotic resistance patterns among group B Streptococcus isolates. Implications for antibiotic prophylaxis for early-onset neonatal sepsis. Swiss Med Wkly. 2013;143:w13778.
  12. Escobar GJ, Li DK, Armstrong MA, et al. Neonatal sepsis workups in infants ≥2000 grams at birth: A population-based study. Pediatrics. 2000;106:256–63.
  13. Ottolini MC, Lundgren K, Mirkinson LJ, et al. Utility of complete blood count and blood culture screening to diagnose neonatal sepsis in the asymptomatic at risk newborn. Ped J Inf Dis. 2003;22(5):430–4.
  14. Bromberger P, Lawrence JM, Braun D. The influence of intrapartum antibiotics on the clinical spectrum of early-onset group B streptococcal infection in term infants. Pediatrics. 2000;106:244–50.
  15. Benitz WE. Adjunct labarotory tests in the diagnosis of early-onset neonatal sepsis. Clin Perinatol. 2010;37:421–38.
  16. Buckler B, Bell J, Sams R, et al. Unnecessary workup of asymptomatic neonates in the era of group B Streptococcus prophylaxis. Inf Dis Obst Gyn 2010.
  17. Jackson GL, Engle WD, Seldelbach DM, et al. Are complete blood cell counts useful in the evaluation of asymptomatic neonates exposed to suspected chorioamnionitis? Pediatrics. 2004;113(4):1173–80.
  18. Newman TB, Puopolo KM, Wi S, et al. Interpreting complete blood counts soon after birth in newborns at risk for sepsis. Pediatrics. 2010;126(5):903–9.
  19. Ng PC, Lam HS. Diagnostic markers for neonatal sepsis. Curr Opin Pediatr. 2006;18:125–31.
  20. Benitz WE, Han MY, Madau A et al. Serial serum C-reactive protein levels in the diagnosis of neonatal infection. Pediatrics. 1998;102:e41.
  21. Pourarous M, Bada HS, Koreones SB, et al. Significance of serial C-reactive protein responses in neonatal infection and other disorders. Pediatrics. 1993;92(3):431–5.
  22. Stocker M, Fontana M, el Helou S, et al. Use of Procalcitonin-guided decision-making to shorten antibiotic therapy in suspected neonatal early-onset sepsis: Prospective randomized intervention study. Neonatology. 2010;97:165–74.
  23. Cheng PJ, Chueh HY, Liu CM, et al. Risk factors for recurrence of group B Streptococcus colonization in a subsequent pregnancy. Obstet Gynecol. 2008;111:704–9.
  24. Turrentine MA, Ramirez MM. Recurrence of group B Streptococci colonization in subsequent pregnancy. Obstet Gynecol. 2008;112:259–64.
  25. Connel TG, Rele M, Cowley D, et al. How reliable is a negative blood culture result? Volume of blood submitted for culture in routine practice in a children’s hospital. Pediatrics. 2007;119:891–6.
  26. Stoll B, Hansen N, Sánchez P, et al for the 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):817–26.
  27. P de Man, Verhoeven BA, Verbrugh HA, et al. An antibiotic policy to prevent emergence of resistant bacilli. Lancet. 2000;355(9208):973–8.
  28. Manzoni P, Farina D, Mallet E, et al. Risk factors for progression to invasive fungal infection in preterm neonates with fungal colonization. Pediatrics. 2006;118(6):2359–64.
  29. Alexander VN, Northrup V, Bizzaro MJ. Antibiotic exposure in the newborn intensive care unit and the risk of necrotizing enterocolitis. J Pediatr. 2011;159:392–7.
  30. Cotton CM, Taylor S, Stoll B et al. Prolonged duration of initial empirical antibiotic treatment is associated with increased rates of necrotizing enterocolitis and death for extremely low birth weight infants. Pediatrics. 2009;123:58–66.
  31. Kuppala VS, Meinzen-Derr J, Morrow AL, et al. Prolonged initial empirical antibiotic treatment is associated with adverse outcomes in premature infants. J Pediatr. 2011;159:720–5.

Most read articles by the same author(s)

<< < 1 2