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Am J Perinatol 2016; 33(08): 800-807
DOI: 10.1055/s-0036-1572432
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Neonatal Nasopharyngeal Colonization with Group B Streptococcus and its Association with Clinical Sepsis

Anuj Malik
1   Department of Pediatrics, Nassau University Medical Center, East Meadow, New York
2   Department of Pediatrics, West Virginia University Children's Hospital, Morgantown, West Virginia
,
Chetna Kothari
1   Department of Pediatrics, Nassau University Medical Center, East Meadow, New York
,
Ammukutty Paulose
1   Department of Pediatrics, Nassau University Medical Center, East Meadow, New York
,
Joshua Fogel
1   Department of Pediatrics, Nassau University Medical Center, East Meadow, New York
3   Department of Business Management, Brooklyn College, Brooklyn, New York
,
Harriet Boxer
1   Department of Pediatrics, Nassau University Medical Center, East Meadow, New York
,
Brinda Doraiswamy
1   Department of Pediatrics, Nassau University Medical Center, East Meadow, New York
› Author Affiliations
Further Information

Publication History

24 July 2015

28 December 2015

Publication Date:
23 February 2016 (online)

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Abstract

Objective This study aims to determine whether nasopharyngeal (NP) colonization with group B streptococcus (GBS) is associated with early-onset clinical sepsis within 72 hours of birth, prolonged antibiotic duration, longer neonatal intensive care unit (NICU) stay, and delay in tolerating full feeds among neonates ≥ 35 weeks gestation.

Study Design A retrospective cohort study of 192 NICU neonates admitted for sepsis evaluation. Based on their GBS colonization status, the mother–neonate pairs were divided into four groups of mother-negative neonate (baby)-positive (MNBP), mother-positive neonate-positive (MPBP), mother-positive neonate-negative (MPBN), and a reference group of mother-negative neonate-negative (MNBN). Neonates with GBS-positive blood cultures were excluded.

Results The colonized neonate groups of MNBP (odds ratio [OR]: 21.8, 95% confidence interval [CI]: 7.99, 59.44) and MPBP (OR: 35.5, 95% CI: 9.57, 131.70) were each associated with increased odds for clinical sepsis (p < 0.001). A similar pattern occurred for prolonged antibiotic use. MPBP group was associated with the increased NICU stay (adjusted β: 0.1, standard error = 0.05, p < 0.01). None of the GBS groups were associated with increased days to full feeds.

Conclusion Neonatal NP GBS colonization was found among a substantial proportion of GBS-negative mothers and was associated with an increased diagnosis of clinical sepsis.

Keywords

group B streptococcus - nasopharyngeal - early-onset sepsis - neonatal screening

Presented in part as a poster at the American Academy of Pediatrics National Conference (October 2013) and the New York Academy of Medicine Pediatric trainee night (February 2014).


 

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