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首页> 外文期刊>Pediatrics: Official Publication of the American Academy of Pediatrics >Association of intrapartum antibiotic exposure and late-onset serious bacterial infections in infants.
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Association of intrapartum antibiotic exposure and late-onset serious bacterial infections in infants.

机译：产时抗生素暴露与婴儿晚期发病严重细菌感染的关联。

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OBJECTIVE: Recommendations to prevent vertical transmission of group B Streptococcus (GBS) infections have resulted in many women's receiving antibiotics during labor with an associated reduction in early-onset GBS infections in their newborn infants. However, a potential relationship of intrapartum antibiotics (IPA) to the occurrence of late-onset (7-90 days) serious bacterial infections (SBIs) in term infants has not been reported. The objectives of this study were to determine whether infants with late-onset SBI were more likely than healthy control infants to have been exposed to IPA and whether there was a greater likelihood of antibiotic resistance in bacteria that were isolated from infants who had an SBI and had been exposed to IPA compared with those who had not. METHODS: We used a case-control design to study the first objective. Cases were previously healthy full-term infants who were hospitalized for late-onset SBI between the ages of 7 and 90 days. Control subjects were healthy full-term infants who were known not to have an SBI in their first 90 days. Cases and control subjects were matched for hospital of delivery. In the second part of the study, rates of antibiotic resistance of bacteria that were isolated from infected infants were compared for those who had and had not been exposed to IPA. RESULTS: Ninety case infants and 92 control subjects were studied. Considering all types of IPA, more case (41%) than control infants (27%) had been exposed to IPA (adjusted odds ratio [OR]: 1.96; 95% confidence interval [CI]: 1.05-3.66), after controlling for hospital of delivery. The association was stronger when IPA was with broad-spectrum antibiotics (adjusted OR: 4.95; 95% CI: 2.04-11.98), after controlling for hospital of delivery, penicillin IPA, maternal chorioamnionitis, and breastfeeding. Bacteria that were isolated from infected infants who had been exposed to IPA were more likely to exhibit ampicillin resistance (adjusted OR: 5.7; 95% CI: 2.3-14.3), after controlling for hospital of delivery, but not to other antibiotics that are commonly used to treat SBI in infants. CONCLUSIONS: After adjusting for potential confounders, infants with late-onset SBI were more likely to have been exposed to IPA than noninfected control infants. Pathogens that cause late-onset SBI were more likely to be resistant to ampicillin when the infant had been exposed to intrapartum antibiotics.
机译：目的：为防止垂直传播B组链球菌（GBS）感染的建议，导致许多妇女在分娩时接受抗生素治疗，从而减少了新生儿的早发性GBS感染。然而，尚未报道足月婴儿中产时抗生素（IPA）与迟发（7-90天）严重细菌感染（SBI）发生的潜在关系。这项研究的目的是确定迟发性SBI婴儿是否比健康对照婴儿更容易接触IPA，以及从SBI和SBI婴儿中分离出的细菌中是否更有可能产生抗生素耐药性。与那些没有接触过IPA的人相比。方法：我们使用病例对照设计来研究第一个目标。病例为先前健康的足月婴儿，他们在7至90天之间因迟发性SBI住院治疗。对照对象是健康的足月婴儿，已知他们在头90天内没有SBI。病例和对照对象匹配到分娩医院。在研究的第二部分中，对从感染婴儿中分离出的细菌与未接触IPA的细菌的抗生素耐药率进行了比较。结果：研究了90例婴儿和92名对照受试者。考虑到所有类型的IPA，在控制了IPA后，接触IPA的病例（41％）多于对照组婴儿（27％）（校正后的优势比[OR]：1.96; 95％可信区间[CI]：1.05-3.66）。分娩医院。在控制分娩医院，青霉素IPA，母亲绒毛膜羊膜炎和母乳喂养后，IPA与广谱抗生素（校正后的OR：4.95; 95％CI：2.04-11.98）相关性更强。在控制分娩医院后，从接触过IPA的感染婴儿中分离出的细菌更有可能表现出氨苄西林抗药性（调整后的OR：5.7; 95％CI：2.3-14.3），但对其他通常不使用的抗生素用于治疗婴儿的SBI。结论：在校正了潜在的混杂因素之后，迟发性SBI婴儿比未感染的对照婴儿更容易接触IPA。当婴儿暴露于分娩期抗生素后，引起迟发性SBI的病原体对氨苄西林的耐药性更高。

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