{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T00:43:55Z","timestamp":1791420235179,"version":"4.3.3"},"reference-count":20,"publisher":"American Academy of Pediatrics (AAP)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2000,1,1]]},"abstract":"<jats:sec>\n                  <jats:title>Background.<\/jats:title>\n                  <jats:p>Early-onset group B streptococcal (GBS) prevention efforts are based on targeted use of intrapartum antibiotic prophylaxis (IAP); applicability of these prevention efforts to infections caused by other organisms is not clear.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods.<\/jats:title>\n                  <jats:p>Multicenter surveillance during 1995 to 1996 for culture-confirmed, early-onset sepsis in an aggregate of 52\u2009406 births; matched case-control study of risk factors for GBS and other sepsis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results.<\/jats:title>\n                  <jats:p>Early-onset disease occurred in 188 infants (3.5 cases per 1000 live births). GBS (1.4 cases per 1000 births) andEscherichia coli (0.6 cases per 1000 births) caused most infections. GBS sepsis less often occurred in preterm deliveries compared with other sepsis. Compared with gestation-matched controls without documented sepsis, GBS disease was associated with intrapartum fever (matched OR, 4.1; CI, 1.2\u201313.4) and frequent vaginal exams (matched OR, 2.9; CI, 1.1\u20138.0). An obstetric risk factor\u2014preterm delivery, intrapartum fever, or membrane rupture \u226518 hours\u2014was found in 49% of GBS cases and 79% of other sepsis. IAP had an adjusted efficacy of 68.2% against any early-onset sepsis. Ampicillin resistance was evident in 69% of E coliinfections. No deaths occurred among susceptible E coliinfections, whereas 41% of ampicillin-resistant E coliinfections were fatal. Ninety-one percent of infants who developed ampicillin-resistant E coli infections were preterm, and 59% of these infants were born to mothers who had received IAP.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions.<\/jats:title>\n                  <jats:p>Either prenatal GBS screening or a risk-based strategy could potentially prevent a substantial portion of GBS cases. Sepsis caused by other organisms is more often a disease of prematurity. IAP seemed efficacious against early-onset sepsis. However, the severity of ampicillin-resistant E colisepsis and its occurrence after maternal antibiotics suggest caution regarding use of ampicillin instead of penicillin for GBS prophylaxis.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1542\/peds.105.1.21","type":"journal-article","created":{"date-parts":[[2004,8,13]],"date-time":"2004-08-13T23:50:41Z","timestamp":1092441041000},"page":"21-26","source":"Crossref","is-referenced-by-count":251,"title":["Risk Factors and Opportunities for Prevention of Early-onset Neonatal Sepsis: A Multicenter Case-Control Study"],"prefix":"10.1542","volume":"105","author":[{"given":"Anne","family":"Schuchat","sequence":"first","affiliation":[{"name":"From the Centers for Disease Control and Prevention, Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara S.","family":"Zywicki","sequence":"additional","affiliation":[{"name":"From the Centers for Disease Control and Prevention, Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mara J.","family":"Dinsmoor","sequence":"additional","affiliation":[{"name":"Medical College of Virginia of Virginia Commonwealth University, Richmond, Virginia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian","family":"Mercer","sequence":"additional","affiliation":[{"name":"University of Tennessee at Memphis, Regional Medical Center, Memphis, Tennessee;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josefina","family":"Romaguera","sequence":"additional","affiliation":[{"name":"University of Puerto Rico, San Juan, Puerto Rico;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary Jo","family":"O'Sullivan","sequence":"additional","affiliation":[{"name":"University of Miami Medical Center\u2013Jackson Memorial Hospital, Miami, Florida;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daksha","family":"Patel","sequence":"additional","affiliation":[{"name":"University of Mississippi Medical Center, Jackson, Mississippi;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark T.","family":"Peters","sequence":"additional","affiliation":[{"name":"Broward General Medical Center, Fort Lauderdale, Florida; and the"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Stoll","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Orin S.","family":"Levine","sequence":"additional","affiliation":[{"name":"From the Centers for Disease Control and Prevention, Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the Prevention of Early-onset Neonatal Sepsis (PENS) Study Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2000,1,1]]},"reference":[{"key":"2021121010275576800_B1","doi-asserted-by":"crossref","first-page":"374","DOI":"10.1093\/oxfordjournals.epirev.a036159","article-title":"Epidemiology of group B streptococcal disease: risk factors, prevention strategies and vaccine development.","volume":"16","author":"Schuchat","year":"1994","journal-title":"Epidemiol Rev."},{"key":"2021121010275576800_B2","doi-asserted-by":"crossref","first-page":"1665","DOI":"10.1056\/NEJM198606263142603","article-title":"Prevention of early-onset neonatal group B streptococcal disease with selective intrapartum chemoprophylaxis.","volume":"314","author":"Boyer","year":"1986","journal-title":"N Engl J Med."},{"key":"2021121010275576800_B3","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1111\/j.1479-828X.1991.tb01797.x","article-title":"Group B streptococcus and neonatal infections: the case for intrapartum chemoprophylaxis.","volume":"31","author":"Garland","year":"1991","journal-title":"Aust N Z J Obstet Gynaecol."},{"key":"2021121010275576800_B4","first-page":"1","article-title":"Prevention of perinatal group B streptococcal disease: a public health perspective.","volume":"45","author":"Schuchat","year":"1996","journal-title":"MMWR Morb Mortal Wkly Rep."},{"key":"2021121010275576800_B5","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1001\/archpedi.152.1.35","article-title":"Neonatal early-onset Escherichia coli disease: the effect of intrapartum ampicillin.","volume":"152","author":"Joseph","year":"1998","journal-title":"Arch Pediatr Adolesc Med."},{"key":"2021121010275576800_B6","doi-asserted-by":"crossref","first-page":"577","DOI":"10.1055\/s-2007-994338","article-title":"Early-onset neonatal sepsis in Pakistan: a case-control study of risk factors in a birth cohort.","volume":"14","author":"Bhutta","year":"1997","journal-title":"Am J Perinatol."},{"key":"2021121010275576800_B7","first-page":"665","article-title":"Adoption of hospital policies for prevention of perinatal group B streptococcal disease\u2014United States, 1997.","volume":"47","author":"Centers for Disease Control and Prevention","year":"1998","journal-title":"MMWR Morb Mortal Wkly Rep."},{"key":"2021121010275576800_B8","first-page":"1","article-title":"Survey shows continued confusion over management of GBS in pregnancy.","volume":"38","author":"American College of Obstetricians and Gynecologists","year":"1994","journal-title":"ACOG Newsletter."},{"key":"2021121010275576800_B9","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1542\/peds.99.3.489","article-title":"Revised guidelines for prevention of early-onset group B streptococcal (GBS) infection.","volume":"99","author":"American Academy of Pediatrics, COID\/COFN","year":"1997","journal-title":"Pediatrics"},{"key":"2021121010275576800_B10","first-page":"487","article-title":"Adverse perinatal outcome and resistant Enterobacteriaceae after antibiotic usage for premature rupture of the membranes and group B streptococcus carriage.","volume":"82","author":"McDuffie","year":"1993","journal-title":"Obstet Gynecol."},{"key":"2021121010275576800_B11","doi-asserted-by":"crossref","first-page":"989","DOI":"10.1001\/jama.1997.03550120049032","article-title":"Antibiotic therapy for reduction of infant morbidity after preterm premature rupture of the membranes.","volume":"278","author":"Mercer","year":"1997","journal-title":"JAMA."},{"key":"2021121010275576800_B12","doi-asserted-by":"crossref","first-page":"879","DOI":"10.1016\/S0002-9378(98)70182-6","article-title":"Potential consequences of widespread antepartal use of ampicillin.","volume":"179","author":"Towers","year":"1998","journal-title":"Am J Obstet Gynecol."},{"key":"2021121010275576800_B13"},{"key":"2021121010275576800_B14","doi-asserted-by":"crossref","first-page":"672","DOI":"10.1093\/infdis\/162.3.672","article-title":"Population-based risk factors for neonatal group B streptococcal disease: results of a cohort study in metropolitan Atlanta.","volume":"162","author":"Schuchat","year":"1990","journal-title":"J Infect Dis."},{"key":"2021121010275576800_B15","doi-asserted-by":"crossref","first-page":"811","DOI":"10.1016\/0029-7844(96)00320-1","article-title":"The accuracy of late antenatal screening cultures in predicting genital group B streptococcal colonization at delivery.","volume":"88","author":"Yancey","year":"1996","journal-title":"Obstet Gynecol."},{"key":"2021121010275576800_B16","first-page":"473","article-title":"Decreasing incidence of perinatal group B streptococcal disease\u2014United States, 1993\u20131995.","volume":"46","author":"Centers for Disease Control and Prevention","year":"1997","journal-title":"MMWR Morb Mortal Wkly Rep."},{"key":"2021121010275576800_B17","first-page":"816","article-title":"Peripartum infection associated with vaginal group B streptococcal colonization.","volume":"84","author":"Yancey","year":"1994","journal-title":"Obstet Gynecol."},{"key":"2021121010275576800_B18","doi-asserted-by":"crossref","first-page":"635","DOI":"10.1016\/S0002-9378(98)70056-0","article-title":"International multicenter term PROM study: evaluation of predictors of neonatal infection in infants born to patients with premature rupture of membranes at term.","volume":"179","author":"Seaward","year":"1998","journal-title":"Am J Obstet Gynecol."},{"key":"2021121010275576800_B19","doi-asserted-by":"crossref","first-page":"623","DOI":"10.1097\/00006454-199407000-00008","article-title":"Multistate case-control study of maternal risk factors for neonatal group B streptococcal disease.","volume":"13","author":"Schuchat","year":"1994","journal-title":"Pediatr Infect Dis J."},{"key":"2021121010275576800_B20","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1016\/S0029-7844(97)00587-5","article-title":"Timing of intrapartum ampicillin and prevention of vertical transmission of group B streptococcus.","volume":"91","author":"de Cueto","year":"1998","journal-title":"Obstet Gynecol."}],"container-title":["Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/105\/1\/21\/842652\/21.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/105\/1\/21\/842652\/21.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,10]],"date-time":"2021-12-10T23:01:20Z","timestamp":1639177280000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/pediatrics\/article\/105\/1\/21\/65685\/Risk-Factors-and-Opportunities-for-Prevention-of"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2000,1,1]]},"references-count":20,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2000,1,1]]},"published-print":{"date-parts":[[2000,1,1]]}},"URL":"https:\/\/doi.org\/10.1542\/peds.105.1.21","relation":{},"ISSN":["1098-4275","0031-4005"],"issn-type":[{"value":"1098-4275","type":"electronic"},{"value":"0031-4005","type":"print"}],"subject":[],"published":{"date-parts":[[2000,1,1]]}}}