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Neonatal group B streptococcus sepsis after negative screen in a patient taking oral antibiotics.

Kim DD, Page SM, McKenna DS, Kim CM

Department of Obstetrics and Gynecology, Wright-Patterson Medical Center, Dayton, Ohio 45433, USA. david.kim@wpafb.af.mil

BACKGROUND: Group B streptococcus (GBS) is a leading cause of serious neonatal infection. Neonatal morbidity and mortality can be reduced by appropriate prenatal screening and intrapartum chemoprophylaxis. CASE: A 20-year-old primigravida was treated with oral antibiotics at 35 weeks for a recurrent urinary tract infection. Her GBS screen following the antibiotic treatment showed a negative culture. The patient, therefore, did not receive intravenous antibiotics during her induction of labor for mild preeclampsia. The infant developed early onset neonatal GBS pneumonia and sepsis. CONCLUSION: Oral antibiotics can cause a temporary negative culture in a GBS-colonized patient. Relying on a negative culture for management may not be appropriate in a patient treated with oral antibiotics. Additional studies are necessary to elucidate the effects of oral antibiotics on GBS.

Published 2 May 2005 in Obstet Gynecol, 105(5): 1259-61.
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