On 1/3/95, we implemented a protocol at PMH for the prophylaxis (PRLX) of early onset GBS disease that combines the administration (ADM) of intrapartum (IP) ampicillin (AMP) to women with obstetrical risk factors and ADM of single dose penicillin (PEN) within 1 hour of delivery to all INF. We reviewed the SUS of INF isolates for GBS from 1/1/94 to 5/1/97 and for GNB 1/1/87 to 5/1/97. All SUS testing was performed by the MicroScan® system. GBS SUS were as follows: AMP (MIC ≤ 0.12), 78/78 (100%); clindamycin (MIC ≤ 0.25), 71/74 (96%); erythromycin (MIC ≤ 4), 70/73 (96%). SUS of 102 strains of E. coli, Enterobacter, Klebsiella, and Serratia sp. for AMP, cefotaxime (CTX), gentamicin (GEN), tobramycin (TOB) were compared for 1987-94 (no GBS IP AMP/PEN) vs.1995-97 (GBS IP AMP/PEN). There were no significant increases in resistance (RES) over time. AMP RES (MIC > 8) for E. coli was not significantly different between the 2 time periods: (22/46,48%) vs. (10/18,56%), p = 0.78. 6% of E. coli were resistant to GEN and TOB. All strains of Klebsiella and Serratia sp. and 79% (11/14) Enterobacter sp. from 1987-97 were resistant to AMP. The only CTX resistant strains were Enterobacter sp. (2/12,17%) and Serratia sp. (1/4,25%). We conclude that in our medical center 1) clindamycin and erythromycin will provide adequate protection against early onset GBS in INF of PEN allergic women and 2) the combined use of AMP for IP PRLX and single dose PEN at birth is not associated with increased RES of GNB causing INF sepsis.
|Original language||English (US)|
|Number of pages||1|
|Journal||Clinical Infectious Diseases|
|State||Published - Dec 1 1997|
ASJC Scopus subject areas
- Microbiology (medical)
- Infectious Diseases