Evaluation of intrapartum antibiotic prophylaxis for the prevention of early-onset group B streptococcal infection.

We retrospectively assessed the medical records of pregnant women who delivered at Asahikawa Kosei Hospital during a period of 3 years between January 2009 and December 2011 and their neonates. Our prophylactic measures against group B Streptococcus (GBS) infection are based on the Japanese guidelines. More specifically, we performed screening by examining bacterial cultures of vaginal-perianal swabs from pregnant women between gestational weeks 33 and 37. Then, sulbactam/ampicillin (SBT/ABPC) was given at a dose of 1.5 g through a drip intravenous infusion at delivery if pregnant women were screened positive for GBS. For neonates born to GBS carrier women, bacterial cultures of pharyngeal swabs, vernix caseosa, stool, and gastric juice were performed at birth. There were 2,399 deliveries and 2,499 births at our hospital. In 169 of the deliveries (175 of the births), GBS was isolated from specimens obtained from gestational weeks 33-37. According to delivery mode, there were 42 cases of cesarean section (45 births) and 127 cases of vaginal delivery (130 births). The GBS-positive neonates accounted for 4.1 % of all deliveries in pregnant women who tested positive for GBS at gestational weeks 33-37. In neonates born by vaginal delivery, the GBS-positive rate was 5.5 %. Of the 2,499 neonates born at our hospital during a period of 3 years, early-onset GBS infection occurred in 1 neonate. The incidence of early-onset GBS infection was 0.40 per 1,000 live births. From 1997 to 2001 (routine GBS screening of mothers was not performed), there were 2,097 deliveries and 2,166 births. Early-onset GBS infection occurred in 1 neonate during this period; thus, the incidence of early-onset GBS infection was 0.46 per 1,000 live births. There were no significant differences in the two periods. The present prophylactic measures such as screening of maternal GBS carriers and intrapartum antibiotic administration are inadequate to decrease the occurrence of early-onset GBS infection.

[The sensitivity of some strains of Klebsiella spp. collected in a neonatal department]. / Sensibilitatea unor tulpini de Klebsiella izolate într-o sectie de nou-nascuti.

In order to analyse the evolution of the sensitivity to antibiotics of same strains with nosocomial potential such as Klebsiella isolated in a hospital, we took into study a number of 976 samples, collected in a new-born care department of the "Dr. D. Popescu" hospital Timisoara. The study took place between November-December 2002. The collected samples were pharyngeal swabs, nasal swabs, gastric aspirates, ocular and umbilical secretions, vernix, urines, faeces and blood. From all these samples 803 strains with nosocomial potential were isolated, 84 strains being Klebsiella spp. Most of the isolated strains presented multiple phenotypes of resistance to antibiotics.

Role of Vernix caseosa in the neonate: potential application in the adult population.

Vernix caseosa is a naturally occurring fetal barrier film produced in late pregnancy as a result of sebaceous and epidermal lipids combined with desquamation of maturing fetal corneocytes. Vernix lacks desmosomal interconnections between corneocytes as demonstrated in adult stratum corneum and is, therefore, referred to as a "mobile phase" stratum corneum. Vernix is proposed to have multiple fetal/newborn overlapping biological functions: moisturization, anti-infective, antioxidant, wound healing, and waterproofing. Patients with altered skin integrity due to burn injuries lack the protective qualities necessary for wound healing. Emerging research suggests that Vernix applied to skin cultures may enhance wound healing. Application of the fetal/neonatal skin science findings to the adult burn population offers the potential for a clinically relevant homologous substitute for impaired tissue integrity.

Barrier properties of vernix caseosa.

Experiments are described which show that vernix caseosa has a mechanical barrier effect if it is deposited in an unbroken layer. Specific antibacterial properties were not detected in vernix. It is suggested that vernix is best left on a newborn infant because of its mechanical obstruction to bacterial passage.