Tags

Type your tag names separated by a space and hit enter

Pathogens in preterm prelabour rupture of membranes and erythromycin for antibiotic prophylaxis: a retrospective analysis.
Hong Kong Med J 2019; 25(4):287-294HK

Abstract

INTRODUCTION

Many authoritative guidelines recommend prescribing erythromycin as antibiotic prophylaxis in patients with preterm prelabour rupture of membranes (PPROM). This study evaluated the spectrum of pathogens in PPROM and assessed the effectiveness of erythromycin prophylaxis.

METHODS

This retrospective study enrolled pregnant patients who were diagnosed with PPROM and who delivered at ≥24 weeks of gestation in an obstetric unit from 2013 to 2017. Pathogens isolated from maternal, placental, and neonatal specimens were analysed; their sensitivity profiles to various antibiotics were recorded. Neonatal outcomes were also evaluated.

RESULTS

The overall incidence of PPROM was 2.63%. Gram-positive bacteria were cultured in 18.4% of PPROM patients (most frequent: Group B Streptococcus [GBS; 14.6%]); Gram-negative bacteria were cultured in 12.8% of PPROM patients (most frequent: Escherichia coli [8.0%]). Both Gram-positive and Gram-negative bacteria were significantly associated with early-onset neonatal sepsis (P=0.036 and P=0.001). In analyses stratified by bacterial species, E coli was significantly associated with early-onset neonatal sepsis (P=0.004), whereas GBS was not (P=0.39). Gram-positive bacteria had high rates of resistance to common antibiotics: 42.2% of GBS and 50.0% of Enterococcus and other Streptococcus bacteria were resistant to erythromycin. Escherichia coli had high rates of resistance to ampicillin (70.3%) and gentamicin (33.3%); rates of resistance to co-amoxiclav (3.6%) and intravenous cefuroxime (14.0%) were low.

CONCLUSION

Gram-positive and Gram-negative bacteria were found in 29.1% of PPROM patients. Administration of erythromycin alone was insufficient to control these bacteria in 67.7% of patients with positive cultures.

Authors+Show Affiliations

Department of Obstetrics and Gynaecology, United Christian Hospital, Kwun Tong, Hong Kong.Department of Obstetrics and Gynaecology, United Christian Hospital, Kwun Tong, Hong Kong.Department of Obstetrics and Gynaecology, United Christian Hospital, Kwun Tong, Hong Kong.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31402340

Citation

Li, Y Y., et al. "Pathogens in Preterm Prelabour Rupture of Membranes and Erythromycin for Antibiotic Prophylaxis: a Retrospective Analysis." Hong Kong Medical Journal = Xianggang Yi Xue Za Zhi, vol. 25, no. 4, 2019, pp. 287-294.
Li YY, Kong CW, To WWK. Pathogens in preterm prelabour rupture of membranes and erythromycin for antibiotic prophylaxis: a retrospective analysis. Hong Kong Med J. 2019;25(4):287-294.
Li, Y. Y., Kong, C. W., & To, W. W. K. (2019). Pathogens in preterm prelabour rupture of membranes and erythromycin for antibiotic prophylaxis: a retrospective analysis. Hong Kong Medical Journal = Xianggang Yi Xue Za Zhi, 25(4), pp. 287-294. doi:10.12809/hkmj197991.
Li YY, Kong CW, To WWK. Pathogens in Preterm Prelabour Rupture of Membranes and Erythromycin for Antibiotic Prophylaxis: a Retrospective Analysis. Hong Kong Med J. 2019;25(4):287-294. PubMed PMID: 31402340.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Pathogens in preterm prelabour rupture of membranes and erythromycin for antibiotic prophylaxis: a retrospective analysis. AU - Li,Y Y, AU - Kong,C W, AU - To,W W K, Y1 - 2019/08/12/ PY - 2019/8/14/pubmed PY - 2019/8/14/medline PY - 2019/8/13/entrez KW - Erythromycin KW - Escherichia coli KW - Fetal membranes, premature rupture KW - Neonatal sepsis KW - Streptococcus SP - 287 EP - 294 JF - Hong Kong medical journal = Xianggang yi xue za zhi JO - Hong Kong Med J VL - 25 IS - 4 N2 - INTRODUCTION: Many authoritative guidelines recommend prescribing erythromycin as antibiotic prophylaxis in patients with preterm prelabour rupture of membranes (PPROM). This study evaluated the spectrum of pathogens in PPROM and assessed the effectiveness of erythromycin prophylaxis. METHODS: This retrospective study enrolled pregnant patients who were diagnosed with PPROM and who delivered at ≥24 weeks of gestation in an obstetric unit from 2013 to 2017. Pathogens isolated from maternal, placental, and neonatal specimens were analysed; their sensitivity profiles to various antibiotics were recorded. Neonatal outcomes were also evaluated. RESULTS: The overall incidence of PPROM was 2.63%. Gram-positive bacteria were cultured in 18.4% of PPROM patients (most frequent: Group B Streptococcus [GBS; 14.6%]); Gram-negative bacteria were cultured in 12.8% of PPROM patients (most frequent: Escherichia coli [8.0%]). Both Gram-positive and Gram-negative bacteria were significantly associated with early-onset neonatal sepsis (P=0.036 and P=0.001). In analyses stratified by bacterial species, E coli was significantly associated with early-onset neonatal sepsis (P=0.004), whereas GBS was not (P=0.39). Gram-positive bacteria had high rates of resistance to common antibiotics: 42.2% of GBS and 50.0% of Enterococcus and other Streptococcus bacteria were resistant to erythromycin. Escherichia coli had high rates of resistance to ampicillin (70.3%) and gentamicin (33.3%); rates of resistance to co-amoxiclav (3.6%) and intravenous cefuroxime (14.0%) were low. CONCLUSION: Gram-positive and Gram-negative bacteria were found in 29.1% of PPROM patients. Administration of erythromycin alone was insufficient to control these bacteria in 67.7% of patients with positive cultures. SN - 1024-2708 UR - https://www.unboundmedicine.com/medline/citation/31402340/Pathogens_in_preterm_prelabour_rupture_of_membranes_and_erythromycin_for_antibiotic_prophylaxis:_a_retrospective_analysis L2 - http://www.hkmj.org/abstracts/v25n4/287.htm DB - PRIME DP - Unbound Medicine ER -