Maternal Group B Streptococcal Rectovaginal Colonization after Intrapartum Antibiotic Prophylaxis

Maternal rectovaginal colonization with Group B Streptococcus (GBS) during labor is a prerequisite for neonatal early-onset GBS disease. Intrapartum antibiotic prophylaxis (IAP) has been proven to prevent GBS perinatal infection, while there are few studies on the evaluation of the effectiveness of...

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Main Authors: Ping Liu, Qiaoli Feng, Yiheng Liang, Xinxin Wang, Zhansong Xiao, Liting Huang, Yun Li, Yuqing Deng, Lin Yu, Yang Xin, Shangrong Fan
Format: Article
Language:English
Published: MDPI AG 2022-11-01
Series:Children
Subjects:
Online Access:https://www.mdpi.com/2227-9067/9/12/1848
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author Ping Liu
Qiaoli Feng
Yiheng Liang
Xinxin Wang
Zhansong Xiao
Liting Huang
Yun Li
Yuqing Deng
Lin Yu
Yang Xin
Shangrong Fan
author_facet Ping Liu
Qiaoli Feng
Yiheng Liang
Xinxin Wang
Zhansong Xiao
Liting Huang
Yun Li
Yuqing Deng
Lin Yu
Yang Xin
Shangrong Fan
author_sort Ping Liu
collection DOAJ
description Maternal rectovaginal colonization with Group B Streptococcus (GBS) during labor is a prerequisite for neonatal early-onset GBS disease. Intrapartum antibiotic prophylaxis (IAP) has been proven to prevent GBS perinatal infection, while there are few studies on the evaluation of the effectiveness of different antibiotic prophylaxis regimens. This study aimed to assess the maternal rectovaginal GBS colonization status after IAP, antimicrobial susceptibility and maternal and neonatal outcomes among women administered different antibiotic prophylaxis regimens. A prospective study was conducted between June 2018 and June 2022. GBS carriers identified at 35–37 weeks of gestation were provided IAP (penicillin, cefazolin or clindamycin) at delivery based on the local protocol for GBS prevention. Rectovaginal samples were obtained from participants again after delivery. Antimicrobial susceptibility testing in GBS isolates was performed using the broth microdilution method. A total of 295 cases were included in this study. In the postpartum re-examination for GBS, the overall negative rectovaginal culture rate was 90.8% (268/295). Women who received cefazolin prophylaxis had the highest negative culture rate (95.2%, 197/207), which was followed by those who received penicillin (80.7%, 67/83) and clindamycin (80.0%, 4/5) (<i>p</i> = 0.001). All GBS isolates achieved sensitivity to penicillin and cefazolin, whereas resistance to clindamycin was shown in 21.4% of the strains. There were no significant differences in maternal and neonatal outcomes among the IAP groups. The use of IAP is highly effective in reducing the maternal rectovaginal GBS colonization. Cefazolin may offer equivalent efficacy and safety compared to standard penicillin prophylaxis.
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spelling doaj.art-30b7da027c2246d3a4969de292b02cd92023-11-24T14:00:47ZengMDPI AGChildren2227-90672022-11-01912184810.3390/children9121848Maternal Group B Streptococcal Rectovaginal Colonization after Intrapartum Antibiotic ProphylaxisPing Liu0Qiaoli Feng1Yiheng Liang2Xinxin Wang3Zhansong Xiao4Liting Huang5Yun Li6Yuqing Deng7Lin Yu8Yang Xin9Shangrong Fan10Department of Obstetrics and Gynecology, Peking University Shenzhen Hospital, Shenzhen 518036, ChinaDepartment of Obstetrics and Gynecology, Peking University Shenzhen Hospital, Shenzhen 518036, ChinaDepartment of Obstetrics and Gynecology, Peking University Shenzhen Hospital, Shenzhen 518036, ChinaDepartment of Obstetrics and Gynecology, Peking University Shenzhen Hospital, Shenzhen 518036, ChinaDepartment of Obstetrics and Gynecology, Peking University Shenzhen Hospital, Shenzhen 518036, ChinaDepartment of Obstetrics and Gynecology, Peking University Shenzhen Hospital, Shenzhen 518036, ChinaDepartment of Obstetrics and Gynecology, Peking University Shenzhen Hospital, Shenzhen 518036, ChinaDepartment of Obstetrics and Gynecology, Peking University Shenzhen Hospital, Shenzhen 518036, ChinaDepartment of Obstetrics and Gynecology, Peking University Shenzhen Hospital, Shenzhen 518036, ChinaDepartment of Obstetrics and Gynecology, Peking University Shenzhen Hospital, Shenzhen 518036, ChinaDepartment of Obstetrics and Gynecology, Peking University Shenzhen Hospital, Shenzhen 518036, ChinaMaternal rectovaginal colonization with Group B Streptococcus (GBS) during labor is a prerequisite for neonatal early-onset GBS disease. Intrapartum antibiotic prophylaxis (IAP) has been proven to prevent GBS perinatal infection, while there are few studies on the evaluation of the effectiveness of different antibiotic prophylaxis regimens. This study aimed to assess the maternal rectovaginal GBS colonization status after IAP, antimicrobial susceptibility and maternal and neonatal outcomes among women administered different antibiotic prophylaxis regimens. A prospective study was conducted between June 2018 and June 2022. GBS carriers identified at 35–37 weeks of gestation were provided IAP (penicillin, cefazolin or clindamycin) at delivery based on the local protocol for GBS prevention. Rectovaginal samples were obtained from participants again after delivery. Antimicrobial susceptibility testing in GBS isolates was performed using the broth microdilution method. A total of 295 cases were included in this study. In the postpartum re-examination for GBS, the overall negative rectovaginal culture rate was 90.8% (268/295). Women who received cefazolin prophylaxis had the highest negative culture rate (95.2%, 197/207), which was followed by those who received penicillin (80.7%, 67/83) and clindamycin (80.0%, 4/5) (<i>p</i> = 0.001). All GBS isolates achieved sensitivity to penicillin and cefazolin, whereas resistance to clindamycin was shown in 21.4% of the strains. There were no significant differences in maternal and neonatal outcomes among the IAP groups. The use of IAP is highly effective in reducing the maternal rectovaginal GBS colonization. Cefazolin may offer equivalent efficacy and safety compared to standard penicillin prophylaxis.https://www.mdpi.com/2227-9067/9/12/1848colonizationgroup b streptococcusintrapartum antibiotic prophylaxis
spellingShingle Ping Liu
Qiaoli Feng
Yiheng Liang
Xinxin Wang
Zhansong Xiao
Liting Huang
Yun Li
Yuqing Deng
Lin Yu
Yang Xin
Shangrong Fan
Maternal Group B Streptococcal Rectovaginal Colonization after Intrapartum Antibiotic Prophylaxis
Children
colonization
group b streptococcus
intrapartum antibiotic prophylaxis
title Maternal Group B Streptococcal Rectovaginal Colonization after Intrapartum Antibiotic Prophylaxis
title_full Maternal Group B Streptococcal Rectovaginal Colonization after Intrapartum Antibiotic Prophylaxis
title_fullStr Maternal Group B Streptococcal Rectovaginal Colonization after Intrapartum Antibiotic Prophylaxis
title_full_unstemmed Maternal Group B Streptococcal Rectovaginal Colonization after Intrapartum Antibiotic Prophylaxis
title_short Maternal Group B Streptococcal Rectovaginal Colonization after Intrapartum Antibiotic Prophylaxis
title_sort maternal group b streptococcal rectovaginal colonization after intrapartum antibiotic prophylaxis
topic colonization
group b streptococcus
intrapartum antibiotic prophylaxis
url https://www.mdpi.com/2227-9067/9/12/1848
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