Intrapartum prophylactic efficacy of ampicillin versus clindamycin in preventing vertical transmission of group B Streptococcus.

AIM: To compare the prophylactic efficacy of ampicillin and clindamycin against vertical transmission of group B Streptococcus from mothers to their infants by evaluating the rates of group B Streptococcus colonisation. METHODS: We retrospectively extracted data for mothers who delivered at Showa University Northern Yokohama Hospital between 1 October 2017 and 31 March 2021 and tested positive for antepartum group B Streptococcus, and their infants. The chi-square test was used to compare the rates of group B Streptococcus colonisation, sepsis, and meningitis. We conducted a multivariate logistic regression analysis, including the time interval between membrane rupture and delivery, chorioamnionitis, and maternal intrapartum fever (≥38.0°C). RESULTS: Two hundred fifty-nine mothers and their infants were eligible. Ampicillin and clindamycin were administered to 150 and 109 mothers, respectively. In the ampicillin and clindamycin groups, 12.0% (18/150) and 37.6% (41/109) infants were group B Streptococcus positive, respectively. The rate of group B Streptococcus colonisation among infants was significantly lower in the ampicillin group (p < 0.001). Multivariate regression analysis showed similar results (p < 0.001). No sepsis or meningitis cases were observed in either group. CONCLUSION: Prophylactic efficacy of clindamycin against the vertical transmission of group B Streptococcus is lower than that of ampicillin.

Is fat content of human milk decreased by infusion?

BACKGROUND: Human milk (HM) is the optimum nutrition for preterm infants. Previous studies showed that tube infusion decreased the fat content in thawed HM. The aim of this study was to determine if freezing­thawing is the main reason for decrease of fat content. In neonatal intensive care units, thawed HM is used in general, therefore the aim of this study was to investigate fat loss during tube infusion with regard to changes in tube size, material, and infusion rate. METHODS: First, pre-infusion and post-infusion fat content was measured in 15 fresh HM, 10 thawed HM and 6 formula samples. We compared post-infusion and pre-infusion fat content as well as the percent decrease in fat concentration among fresh HM, thawed HM and formula samples. Second, we measured the fat content of 160 thawed HM samples infused via four different diameters (3­6 Fr), two types of material (DEHP-free and PVC-free), and two infusion rates (30 or 60 min). We compared the percent decrease in fat concentration among four different tube sizes, between DEHP-free and PVC-free tubes, and between 30 and 60 min infusion durations. RESULTS: Post-infusion fat content was significantly decreased compared to before infusion in thawed HM and fresh HM but not in formula. Given that thawed HM resulted in larger decrease in fat content, we performed a second experiment and found no difference regarding differing size, materials or infusion rate. CONCLUSIONS: There was a far greater decrease in the post-infusion fat content of thawed HM compared to fresh HM under all test conditions.