Influence of intrapartum chemoprophylaxis on the incidence and identification of vertically transmitted neonatal sepsis

ABSTRACT

The purpose of the present work was to detect the influence of the use of intrapartum chemoprophylaxis on the incidence of vertically transmitted neonatal sepsis. One hundred and fifty pregnant women at labor with risk factors of delivering an infant with neonatal sepsis were selected from patients attending the labor ward at El Shatby Maternity University hospital. The studied women were divided into two groups according to whether they received intrapartum antibiotic prophylaxis or not. For every case, complete sheet was recorded; complete general and local examination was done to detect PROM and chorioamnionitis and maternal high vaginal swab was obtained and cultured for detection of GBS colonization. One hundred and fifty four infants were born to these mothers and were tested for signs of sepsis through clinical examination, complete laboratory investigations including complete blood count, urine GBS latex agglutination test, C-reactive protein, erythrocyte sedimentation rate, blood culture, and lumbar puncture in blood culture positive infants. The overall incidence of neonatal sepsis in the present study was 16.9%. Group II infants showed a higher incidence of sepsis. As regards GBS colonization, 30 women [20%] had a positive high vaginal swap for GBS. Two GBS carrier mothers delivered infants who developed neonatal sepsis, but caused by other organisms. GBS Organisms isolated from the septic infants were mainly gram-negative organisms and staphylococci. With the exception of 6 cases of E-coli, all other isolates were ampicillin resistant, giving an ampicillin resistance of 76.9%. Most organisms with the exception of staphylococci showed gentamicin sensitivity that might explain the lower incidence of sepsis in group I