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Am J Perinatol 2019; 36(06): 555-560
DOI: 10.1055/s-0038-1675622
SMFM Fellowship Series Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

The Effect of Intrapartum Vancomycin on Vaginal Group B Streptococcus Colony Counts

Maureen S. Hamel
1   Department of Obstetrics and Gynecology, Women and Infants Hospital, Warren Alpert Medical School of Brown University, Providence, Rhode Island
,
Phinnara Has
1   Department of Obstetrics and Gynecology, Women and Infants Hospital, Warren Alpert Medical School of Brown University, Providence, Rhode Island
,
Ilina Datkhaeva
2   Department of Obstetrics and Gynecology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California
,
Kimberly Delacy
3   Department of Microbiology, Women and Infants Hospital, Warren Alpert Medical School of Brown University, Providence, Rhode Island
,
Dana Ciolfi
3   Department of Microbiology, Women and Infants Hospital, Warren Alpert Medical School of Brown University, Providence, Rhode Island
,
Brenna Hughes
4   Department of Obstetrics and Gynecology, Duke University, Durham, North Carolina
› Author Affiliations Funding None.
Further Information

Publication History

07 June 2018

24 September 2018

Publication Date:
16 November 2018 (online)

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Abstract

Objective To define the temporal relationship between intrapartum intravenous vancomycin administration and vaginal group B streptococcus (GBS) colony counts.

Study Design Prospective cohort study conducted from October 2014 to February 2017. Women with antenatal cultures demonstrating GBS colonization and a plan for vancomycin administration were eligible. Intrapartum vaginal cultures were collected prior to the first vancomycin infusion and every 2 hours up to five collections or delivery. Results were analyzed in two groups: participants with at least one positive intrapartum culture and those without any positive intrapartum cultures.

Results A total of 63 women were enrolled. Among consented women, a total of 8 were excluded and 3 participants' cultures were never plated, thus leaving a total of 52 women for analysis. The degree of vaginal GBS colonization varied between subjects and was not normally distributed. Colony counts dropped rapidly from hour 0 to hour 2 (median: 6.0 × 108 vs. 1.0 × 108, p < 0.01). Standardizing hour 0 colony counts to 100%, the percent decline in colony counts from hour 0 to hour 2 was significant (p = 0.03), and at each subsequent time point fell further.

Conclusion GBS vaginal colony counts fall rapidly after intrapartum vancomycin administration.

Keywords

GBS prophylaxis - intrapartum antibiotics - intrapartum antibiotic prophylaxis - intrapartum vancomycin - vaginal GBS colony counts - vancomycin

Condensation

Similar to intrapartum penicillin and intrapartum clindamycin, intrapartum intravenous vancomycin decreases vaginal group B streptococcus colony counts.


Note

Findings from this study were presented at the 44th Annual Meeting of the Infectious Disease Society of Obstetrics and Gynecology, Park City, UT, August 10–12, 2017.