ABSTRACT
From July 1999 to November 1999, 901 pregnant women at Srinagarind Hospital, who fulfilled the criteria and had signed consent forms, were cultured from the lower vagina and perineum for group B streptococcus (GBS). Their neonates were also cultured from ears and anuses within 30 minutes after birth. There were 56 cases or 6.22 per cent colonization in pregnant mothers at the onset of labor and 14 cases or 1.55 per cent colonization in their neonates. Risk factors for GBS colonization in mothers were intrapartum fever and episiotomy. The risk factors for GBS colonization in the neonates were; 1. husband's occupation, 2. antepartum fever, 3. intrapartum fever, 4. postpartum morbidity and 5. gestational age. No cases during the study period had clinical infection from GBS. The prevalence rate in this study was much lower than the United States but similar to many developing countries. At this moment, it is not possible to culture for GBS in all pregnant women in Thailand. Intrapartum antibiotic prophylaxis for GBS infection was recommended if, 1. maternal fever was more than 38 degrees C, 2. ruptured membranes of more than 18 hours and 3. previous birth with neonatal GBS infection.
Subject(s)
Female , Humans , Infant, Newborn , Infectious Disease Transmission, Vertical , Pregnancy , Prevalence , Risk Factors , Streptococcal Infections/epidemiology , Streptococcus agalactiae/isolation & purification , Thailand/epidemiologyABSTRACT
Three years' data were analysed to assess the risk factors for neonatal Klebsiella septicemia in Srinagarind Hospital. The incidence of Klebsiella septicemia was 4.1 per 1,000 livebirths or 5.2 per 100 discharged infants. Eighty-two per cent of infected cases were low birth weight infants and 67.7% were born prematurely. From multivariate analysis, the risk factors were endotracheal intubation (OR 31.57, 95% CI 289-343.82) and central venous catheterization (OR 16.99, 95% CI1.15-250.37). The overall mortality rate was 67.7%. Periodic review and continuous reinforcement of infection control policies in the neonatal unit are of paramount importance to decrease the incidence of nosocomial infection and successful control of outbreaks as well.