Perinatal antibiotic usage and changes in colonization and resistance rates of group B streptococcus and other pathogens

Renee Spaetgens, Kim DeBella, Doreen Ma, Sheila Robertson, Melissa Mucenski, H. Dele Davies

Research output: Contribution to journalArticle

44 Citations (Scopus)

Abstract

OBJECTIVE: To quantify current antibiotic usage during the perinatal period and impact on vaginal-rectal colonizing organism resistance rates. METHODS: Swabs were obtained for culture of group B streptococcus and other bacteria from a cohort of 1207 pregnant women in Calgary, Alberta, at 36 weeks' gestation. Those women who received antibiotics during labor or after pregnancy and a 10% subset who received no antibiotics had repeat cultures at 6 weeks postpartum. Cultured organisms were tested for sensitivity to several antibiotics. RESULTS: Group B streptococcus was identified in 235 women (19.5%) in the antepartum period. Fifty-one percent of all participants received antibiotics (31.4% intrapartum). Group B streptococcus prophylaxis was given to 215 (17.8%), whereas 83 (6.9%) group B streptococcus-negative women without fever during labor received antibiotics. Ampicillin (49%), cefazolin (28%), and penicillin (18%) were the most frequently used antibiotics. Resistance rates among group B streptococcus to erythromycin and clindamycin were 5.6% and 3.0%, respectively, whereas 20.6% of Escherichia coli were ampicillin resistant. Among antibiotic recipients, 6.3% of all bacteria that were initially sensitive on prenatal cultures to a specific antibiotic became resistant in the postnatal period, whereas 6.5% that were initially resistant became sensitive. CONCLUSION: Current prevention practices in our region were associated with perinatal antibiotic administration in over half of pregnant women. Ampicillin was the most common antibiotic administered. Some physicians are treating women who are group B streptococcus culture negative at term, a practice that is of no proven value. However, this was not associated with increased resistance for group B streptococcus or other organisms identified from maternal vaginal-rectal tracts.

Original languageEnglish (US)
Pages (from-to)525-533
Number of pages9
JournalObstetrics and gynecology
Volume100
Issue number3
DOIs
StatePublished - Sep 1 2002

Fingerprint

Streptococcus agalactiae
Anti-Bacterial Agents
Ampicillin
Pregnant Women
Bacteria
Cefazolin
Pregnancy
Alberta
Clindamycin
Erythromycin
Streptococcus
Penicillins
Postpartum Period
Fever
Mothers
Escherichia coli
Physicians

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Perinatal antibiotic usage and changes in colonization and resistance rates of group B streptococcus and other pathogens. / Spaetgens, Renee; DeBella, Kim; Ma, Doreen; Robertson, Sheila; Mucenski, Melissa; Dele Davies, H.

In: Obstetrics and gynecology, Vol. 100, No. 3, 01.09.2002, p. 525-533.

Research output: Contribution to journalArticle

Spaetgens, Renee ; DeBella, Kim ; Ma, Doreen ; Robertson, Sheila ; Mucenski, Melissa ; Dele Davies, H. / Perinatal antibiotic usage and changes in colonization and resistance rates of group B streptococcus and other pathogens. In: Obstetrics and gynecology. 2002 ; Vol. 100, No. 3. pp. 525-533.
@article{a3fb503bb4ae4cd289407e3c1c717f4f,
title = "Perinatal antibiotic usage and changes in colonization and resistance rates of group B streptococcus and other pathogens",
abstract = "OBJECTIVE: To quantify current antibiotic usage during the perinatal period and impact on vaginal-rectal colonizing organism resistance rates. METHODS: Swabs were obtained for culture of group B streptococcus and other bacteria from a cohort of 1207 pregnant women in Calgary, Alberta, at 36 weeks' gestation. Those women who received antibiotics during labor or after pregnancy and a 10{\%} subset who received no antibiotics had repeat cultures at 6 weeks postpartum. Cultured organisms were tested for sensitivity to several antibiotics. RESULTS: Group B streptococcus was identified in 235 women (19.5{\%}) in the antepartum period. Fifty-one percent of all participants received antibiotics (31.4{\%} intrapartum). Group B streptococcus prophylaxis was given to 215 (17.8{\%}), whereas 83 (6.9{\%}) group B streptococcus-negative women without fever during labor received antibiotics. Ampicillin (49{\%}), cefazolin (28{\%}), and penicillin (18{\%}) were the most frequently used antibiotics. Resistance rates among group B streptococcus to erythromycin and clindamycin were 5.6{\%} and 3.0{\%}, respectively, whereas 20.6{\%} of Escherichia coli were ampicillin resistant. Among antibiotic recipients, 6.3{\%} of all bacteria that were initially sensitive on prenatal cultures to a specific antibiotic became resistant in the postnatal period, whereas 6.5{\%} that were initially resistant became sensitive. CONCLUSION: Current prevention practices in our region were associated with perinatal antibiotic administration in over half of pregnant women. Ampicillin was the most common antibiotic administered. Some physicians are treating women who are group B streptococcus culture negative at term, a practice that is of no proven value. However, this was not associated with increased resistance for group B streptococcus or other organisms identified from maternal vaginal-rectal tracts.",
author = "Renee Spaetgens and Kim DeBella and Doreen Ma and Sheila Robertson and Melissa Mucenski and {Dele Davies}, H.",
year = "2002",
month = "9",
day = "1",
doi = "10.1016/S0029-7844(02)02068-9",
language = "English (US)",
volume = "100",
pages = "525--533",
journal = "Obstetrics and Gynecology",
issn = "0029-7844",
publisher = "Lippincott Williams and Wilkins",
number = "3",

}

TY - JOUR

T1 - Perinatal antibiotic usage and changes in colonization and resistance rates of group B streptococcus and other pathogens

AU - Spaetgens, Renee

AU - DeBella, Kim

AU - Ma, Doreen

AU - Robertson, Sheila

AU - Mucenski, Melissa

AU - Dele Davies, H.

PY - 2002/9/1

Y1 - 2002/9/1

N2 - OBJECTIVE: To quantify current antibiotic usage during the perinatal period and impact on vaginal-rectal colonizing organism resistance rates. METHODS: Swabs were obtained for culture of group B streptococcus and other bacteria from a cohort of 1207 pregnant women in Calgary, Alberta, at 36 weeks' gestation. Those women who received antibiotics during labor or after pregnancy and a 10% subset who received no antibiotics had repeat cultures at 6 weeks postpartum. Cultured organisms were tested for sensitivity to several antibiotics. RESULTS: Group B streptococcus was identified in 235 women (19.5%) in the antepartum period. Fifty-one percent of all participants received antibiotics (31.4% intrapartum). Group B streptococcus prophylaxis was given to 215 (17.8%), whereas 83 (6.9%) group B streptococcus-negative women without fever during labor received antibiotics. Ampicillin (49%), cefazolin (28%), and penicillin (18%) were the most frequently used antibiotics. Resistance rates among group B streptococcus to erythromycin and clindamycin were 5.6% and 3.0%, respectively, whereas 20.6% of Escherichia coli were ampicillin resistant. Among antibiotic recipients, 6.3% of all bacteria that were initially sensitive on prenatal cultures to a specific antibiotic became resistant in the postnatal period, whereas 6.5% that were initially resistant became sensitive. CONCLUSION: Current prevention practices in our region were associated with perinatal antibiotic administration in over half of pregnant women. Ampicillin was the most common antibiotic administered. Some physicians are treating women who are group B streptococcus culture negative at term, a practice that is of no proven value. However, this was not associated with increased resistance for group B streptococcus or other organisms identified from maternal vaginal-rectal tracts.

AB - OBJECTIVE: To quantify current antibiotic usage during the perinatal period and impact on vaginal-rectal colonizing organism resistance rates. METHODS: Swabs were obtained for culture of group B streptococcus and other bacteria from a cohort of 1207 pregnant women in Calgary, Alberta, at 36 weeks' gestation. Those women who received antibiotics during labor or after pregnancy and a 10% subset who received no antibiotics had repeat cultures at 6 weeks postpartum. Cultured organisms were tested for sensitivity to several antibiotics. RESULTS: Group B streptococcus was identified in 235 women (19.5%) in the antepartum period. Fifty-one percent of all participants received antibiotics (31.4% intrapartum). Group B streptococcus prophylaxis was given to 215 (17.8%), whereas 83 (6.9%) group B streptococcus-negative women without fever during labor received antibiotics. Ampicillin (49%), cefazolin (28%), and penicillin (18%) were the most frequently used antibiotics. Resistance rates among group B streptococcus to erythromycin and clindamycin were 5.6% and 3.0%, respectively, whereas 20.6% of Escherichia coli were ampicillin resistant. Among antibiotic recipients, 6.3% of all bacteria that were initially sensitive on prenatal cultures to a specific antibiotic became resistant in the postnatal period, whereas 6.5% that were initially resistant became sensitive. CONCLUSION: Current prevention practices in our region were associated with perinatal antibiotic administration in over half of pregnant women. Ampicillin was the most common antibiotic administered. Some physicians are treating women who are group B streptococcus culture negative at term, a practice that is of no proven value. However, this was not associated with increased resistance for group B streptococcus or other organisms identified from maternal vaginal-rectal tracts.

UR - http://www.scopus.com/inward/record.url?scp=0036711293&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0036711293&partnerID=8YFLogxK

U2 - 10.1016/S0029-7844(02)02068-9

DO - 10.1016/S0029-7844(02)02068-9

M3 - Article

C2 - 12220773

AN - SCOPUS:0036711293

VL - 100

SP - 525

EP - 533

JO - Obstetrics and Gynecology

JF - Obstetrics and Gynecology

SN - 0029-7844

IS - 3

ER -