{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T12:29:23Z","timestamp":1791203363668,"version":"4.2.0"},"reference-count":32,"publisher":"American Academy of Pediatrics (AAP)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2008,4,1]]},"abstract":"<jats:p>OBJECTIVE. The goal was to determine current trends in Escherichia coli-related early- and late-onset sepsis and patterns of ampicillin resistance in relation to institutional changes in the use of intrapartum antibiotic prophylaxis.<\/jats:p><jats:p>METHODS. A retrospective review of data for all infants with E coli sepsis at Yale-New Haven Hospital from 1979 to 2006 was performed. Study periods were based on predominant intrapartum antibiotic prophylaxis practices at Yale-New Haven Hospital, that is, (1) 1979 to 1992 (no formal intrapartum antibiotic prophylaxis), (2) 1993 to 1996 (risk factor-based), and (3) 1997 to 2006 (screening-based). Sepsis rates and patterns of ampicillin resistance were compared.<\/jats:p><jats:p>RESULTS. Fifty-three cases of E coli early-onset sepsis and 129 cases of E coli late-onset sepsis were identified over 3 eras. In very low birth weight (&amp;lt;1500 g) infants, increases in E coli early-onset sepsis (period 1: 2.83 cases per 1000 very low birth weight admissions; period 2: 7.12 cases per 1000 very low birth weight admissions; period 3: 10.22 cases per 1000 very low birth weight admissions), intrapartum ampicillin exposure, and ampicillin-resistant E coli were observed. Intrapartum ampicillin exposure was determined to be an independent risk factor for ampicillin-resistant E coli early-onset sepsis. For the first time, a significant increase in E coli late-onset sepsis was observed in preterm infants (period 1: 10.39 cases per 1000 very low birth weight admissions; period 2: 16.01 cases per 1000 very low birth weight admissions; period 3: 21.66 cases per 1000 very low birth weight admissions) and term infants (period 1: 4.07 cases per 1000 admissions; period 2: 4.22 cases per 1000 admissions; period 3: 8.23 cases per 1000 admissions).<\/jats:p><jats:p>CONCLUSIONS. Studies to provide a better understanding of potential consequences of intrapartum antibiotic exposure and its contribution to evolving trends in neonatal sepsis are urgently needed.<\/jats:p>","DOI":"10.1542\/peds.2007-2171","type":"journal-article","created":{"date-parts":[[2008,4,1]],"date-time":"2008-04-01T20:25:58Z","timestamp":1207081558000},"page":"689-696","source":"Crossref","is-referenced-by-count":229,"title":["Changing Patterns in Neonatal<i>Escherichia coli<\/i>Sepsis and Ampicillin Resistance in the Era of Intrapartum Antibiotic Prophylaxis"],"prefix":"10.1542","volume":"121","author":[{"given":"Matthew J.","family":"Bizzarro","sequence":"first","affiliation":[{"name":"Divisions of Perinatal Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louise-Marie","family":"Dembry","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine"},{"name":"Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven, Connecticut"},{"name":"Department of Quality Improvement Support Services, Yale-New Haven Hospital, New Haven, Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert S.","family":"Baltimore","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven, Connecticut"},{"name":"Department of Quality Improvement Support Services, Yale-New Haven Hospital, New Haven, Connecticut"},{"name":"Infectious Diseases, Department of Pediatrics"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick G.","family":"Gallagher","sequence":"additional","affiliation":[{"name":"Divisions of Perinatal Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2008,4,1]]},"reference":[{"key":"2021120902102258000_R1","doi-asserted-by":"crossref","unstructured":"Anthony BF, Okada DM. The emergence of group B streptococci in infections of the newborn infant. Annu Rev Med.\u20081977;28:355\u2013369","DOI":"10.1146\/annurev.me.28.020177.002035"},{"key":"2021120902102258000_R2","doi-asserted-by":"crossref","unstructured":"American Academy of Pediatrics, Committee on Infectious Diseases and Committee on Fetus and Newborn. Guidelines for prevention of group B streptococcal (GBS) infection by chemoprophylaxis. Pediatrics.\u20081992;90(5):775\u2013778","DOI":"10.1542\/peds.90.5.775"},{"key":"2021120902102258000_R3","unstructured":"Centers for Disease Control and Prevention. Prevention of perinatal group B streptococcal disease: a public health perspective. MMWR Recomm Rep.\u20081996;45(RR-7):1\u201324"},{"key":"2021120902102258000_R4","doi-asserted-by":"crossref","unstructured":"American College of Obstetricians and Gynecologists, Committee on Obstetric Practice. ACOG committee opinion: prevention of early-onset group B streptococcal disease in newborns. Int J Gynaecol Obstet.\u20081996;54(2):197\u2013205","DOI":"10.1016\/S0020-7292(96)90083-1"},{"key":"2021120902102258000_R5","unstructured":"Schrag S, Gorwitz R, Fultz-Butts K, Schuchat A. Prevention of perinatal group B streptococcal disease: revised guidelines from CDC. MMWR Recomm Rep.\u20082002;51(RR-11):1\u201322"},{"key":"2021120902102258000_R6","unstructured":"Centers for Disease Control and Prevention. Early-onset group B streptococcal disease: United States, 1998\u20131999. MMWR Morb Mortal Wkly Rep.\u20082000;49(35):793\u2013796"},{"key":"2021120902102258000_R7","doi-asserted-by":"crossref","unstructured":"Stoll BJ, Hansen N. Infections in VLBW infants: studies from the NICHD Neonatal Research Network. Semin Perinatol.\u20082003;27(4):293\u2013301","DOI":"10.1016\/S0146-0005(03)00046-6"},{"key":"2021120902102258000_R8","doi-asserted-by":"crossref","unstructured":"Gilbert GL, Hewitt MC, Turner CM, Leeder SR. Compliance with protocols for prevention of neonatal group B streptococcal sepsis: practicalities and limitations. Infect Dis Obstet Gynecol.\u20082003;11(1):1\u20139","DOI":"10.1155\/S1064744903000012"},{"key":"2021120902102258000_R9","unstructured":"American College of Obstetricians and Gynecologists. ACOG practice bulletin: premature rupture of membranes: clinical management guidelines for obstetrician-gynecologists. Int J Gynaecol Obstet.\u20081998;63(1):75\u201384"},{"key":"2021120902102258000_R10","doi-asserted-by":"crossref","unstructured":"Norman K, Pattinson RC, de Souza J, et al. Ampicillin and metronidazole treatment in preterm labour: a multicentre, randomised, controlled trial. Br J Obstet Gynaecol.\u20081994;101(5):404\u2013408","DOI":"10.1111\/j.1471-0528.1994.tb11912.x"},{"key":"2021120902102258000_R11","doi-asserted-by":"crossref","unstructured":"Kotloff KL, Blackmon LR, Tenney JH, et al. Nosocomial sepsis in the neonatal intensive care unit. South Med J.\u20081989;82(6):699\u2013704","DOI":"10.1097\/00007611-198906000-00007"},{"key":"2021120902102258000_R12","doi-asserted-by":"crossref","unstructured":"Andrews JI, Diekema DJ, Hunter SK, et al. Group B streptococci causing neonatal bloodstream infection: antimicrobial susceptibility and serotyping results from SENTRY centers in the Western Hemisphere. Am J Obstet Gynecol.\u20082000;183(4):859\u2013862","DOI":"10.1067\/mob.2000.108839"},{"key":"2021120902102258000_R13","doi-asserted-by":"crossref","unstructured":"Bland ML, Vermillion ST, Soper DE, et al. Antibiotic resistance patterns of group B streptococci in late third-trimester rectovaginal cultures. Am J Obstet Gynecol.\u20082001;184(6):1125\u20131126","DOI":"10.1067\/mob.2001.115478"},{"key":"2021120902102258000_R14","doi-asserted-by":"crossref","unstructured":"Lin FY, Azimi PH, Weisman LE, et al. Antibiotic susceptibility profiles for group B streptococci isolated from neonates, 1995\u20131998. Clin Infect Dis.\u20082000;31(1):76\u201379","DOI":"10.1086\/313936"},{"key":"2021120902102258000_R15","doi-asserted-by":"crossref","unstructured":"Stoll BJ, Hansen N, Fanaroff AA, et al. Changes in the pathogens causing early-onset sepsis in very-low-birth-weight infants. N Engl J Med.\u20082002;347(4):240\u2013247","DOI":"10.1056\/NEJMoa012657"},{"key":"2021120902102258000_R16","doi-asserted-by":"crossref","unstructured":"Baltimore RS, Huie SM, Meek JI, et al. Early-onset sepsis in the era of group B streptococcal prevention. Pediatrics.\u20082001;108(5):1094\u20131098","DOI":"10.1542\/peds.108.5.1094"},{"key":"2021120902102258000_R17","doi-asserted-by":"crossref","unstructured":"Cordero L, Rau R, Taylor D, et al. Enteric Gram-negative bacilli bloodstream infections: 17 years\u2019 experience in a neonatal intensive care unit. Am J Infect Control.\u20082004;32(4):189\u2013195","DOI":"10.1016\/j.ajic.2003.07.004"},{"key":"2021120902102258000_R18","doi-asserted-by":"crossref","unstructured":"Towers CV, Briggs GC. Antepartum use of antibiotics and early-onset neonatal sepsis: the next 4 years. Am J Obstet Gynecol.\u20082002;187(2):495\u2013500","DOI":"10.1067\/mob.2002.124277"},{"key":"2021120902102258000_R19","doi-asserted-by":"crossref","unstructured":"Hyde TB, Hilger TM, Reingold A, Farley MM, O'Brien KL, Schuchat A. Trends in incidence and antimicrobial resistance of early-onset sepsis: population-based surveillance in San Francisco and Atlanta. Pediatrics.\u20082002;110(4):690\u2013695","DOI":"10.1542\/peds.110.4.690"},{"key":"2021120902102258000_R20","doi-asserted-by":"crossref","unstructured":"Moore MR, Schrag SJ, Schuchat A. Effects of intrapartum antimicrobial prophylaxis for prevention of group-B-streptococcal disease on the incidence and ecology of early onset neonatal sepsis. Lancet Infect Dis.\u20082003;3(4):201\u2013213","DOI":"10.1016\/S1473-3099(03)00577-2"},{"key":"2021120902102258000_R21","doi-asserted-by":"crossref","unstructured":"Stoll BJ, Hansen NI, Higgins RD, et al. Very low birth weight preterm infants with early onset neonatal sepsis. Pediatr Infect Dis J.\u20082005;24(7):635\u2013639","DOI":"10.1097\/01.inf.0000168749.82105.64"},{"key":"2021120902102258000_R22","doi-asserted-by":"crossref","unstructured":"Stoll BJ, Hansen N, Fanaroff AA, et al. Late-onset sepsis in very low birth weight neonates: the experience of the NICHD Neonatal Research Network. Pediatrics.\u20082002;110(2):285\u2013291","DOI":"10.1542\/peds.110.2.285"},{"key":"2021120902102258000_R23","doi-asserted-by":"crossref","unstructured":"Jones B, Peake K, Morris AJ, et al. Escherichia coli: a growing problem in early onset neonatal sepsis. Aust N Z J Obstet Gynaecol.\u20082004;44(6):558\u2013561","DOI":"10.1111\/j.1479-828X.2004.00304.x"},{"key":"2021120902102258000_R24","doi-asserted-by":"crossref","unstructured":"Schuchat A, Zywicki SS, Dinsmoor MJ, et al. Risk factors and opportunities for the prevention of early-onset neonatal sepsis: a multicenter case-control study. Pediatrics.\u20082000;105(1):21\u201326","DOI":"10.1542\/peds.105.1.21"},{"key":"2021120902102258000_R25","doi-asserted-by":"crossref","unstructured":"Bizzarro MJ, Raskind C, Baltimore RS, et al. Seventy-five years of neonatal sepsis at Yale: 1928\u20132003. Pediatrics.\u20082005;116(3):595\u2013602","DOI":"10.1542\/peds.2005-0552"},{"key":"2021120902102258000_R26","doi-asserted-by":"crossref","unstructured":"Shah SS, Ehrenkranz RA, Gallagher PG. Increasing incidence of Gram-negative rod bacteremia in a newborn intensive care unit. Pediatr Infect Dis J.\u20081999;18(7):591\u2013595","DOI":"10.1097\/00006454-199907000-00005"},{"key":"2021120902102258000_R27","unstructured":"National Committee for Clinical Laboratory Standards. Performance Standards for Antimicrobial Disk Susceptibility Tests. 5th ed. Approved Standard M2-A5. Villanova, PA: National Committee for Clinical Laboratory Standards; 1993"},{"key":"2021120902102258000_R28","doi-asserted-by":"crossref","unstructured":"Speer ME, Taber LH, Yow MD, et al. Culminant neonatal sepsis and necrotizing enterocolitis associated with a \u201cnonenteropathogenetic\u201d strain of Escherichia coli. J Pediatr.\u20081976;89(1):91\u201395","DOI":"10.1016\/S0022-3476(76)80939-0"},{"key":"2021120902102258000_R29","doi-asserted-by":"crossref","unstructured":"Krediet TG, van Lelyveld N, Vijlbrief DC, et al. Microbiologic factors associated with neonatal necrotizing enterocolitis: protective effect of early antibiotic treatment. Acta Paediatr.\u20082003;92(10):1180\u20131182","DOI":"10.1111\/j.1651-2227.2003.tb02481.x"},{"key":"2021120902102258000_R30","doi-asserted-by":"crossref","unstructured":"Fanaroff AA, Korones SB, Wright LL, et al. Incidence, presenting features, risk factors, and significance of late onset septicemia in very low birth weight infants. Pediatr Infect Dis J.\u20081998;17(7):593\u2013598","DOI":"10.1097\/00006454-199807000-00004"},{"key":"2021120902102258000_R31","doi-asserted-by":"crossref","unstructured":"Mercer BM, Moronic M, Thurgau GR, et al. Antibiotic therapy for reduction of infant morbidity after preterm premature rupture of membranes: a randomized controlled trial. JAMA.\u20081997;278(12):989\u2013995","DOI":"10.1001\/jama.278.12.989"},{"key":"2021120902102258000_R32","doi-asserted-by":"crossref","unstructured":"Klein LL, Gibbs RS. Use of microbial cultures and antibiotics in the prevention of infection-associated preterm birth. Am J Obstet Gynecol.\u20082004;190(6):1493\u20131502","DOI":"10.1016\/j.ajog.2004.03.014"}],"container-title":["Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/121\/4\/689\/1123579\/zpe00408000689.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/121\/4\/689\/1123579\/zpe00408000689.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,5,17]],"date-time":"2023-05-17T11:30:41Z","timestamp":1684323041000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/pediatrics\/article\/121\/4\/689\/70812\/Changing-Patterns-in-Neonatal-Escherichia-coli"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2008,4,1]]},"references-count":32,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2008,4,1]]},"published-print":{"date-parts":[[2008,4,1]]}},"URL":"https:\/\/doi.org\/10.1542\/peds.2007-2171","relation":{},"ISSN":["0031-4005","1098-4275"],"issn-type":[{"value":"0031-4005","type":"print"},{"value":"1098-4275","type":"electronic"}],"subject":[],"published":{"date-parts":[[2008,4,1]]}}}