Maureen S Hamel1, Phinnara Has1, Ilina Datkhaeva2, Kimberly Delacy3, Dana Ciolfi3, Brenna Hughes4. 1. Department of Obstetrics and Gynecology, Women and Infants Hospital, Warren Alpert Medical School of Brown University, Providence, Rhode Island. 2. Department of Obstetrics and Gynecology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California. 3. Department of Microbiology, Women and Infants Hospital, Warren Alpert Medical School of Brown University, Providence, Rhode Island. 4. Department of Obstetrics and Gynecology, Duke University, Durham, North Carolina.
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. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
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. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
Authors: Cassandra R Duffy; Yongmei Huang; Maria Andrikopoulou; Conrad N Stern-Ascher; Jason D Wright; Mary E D'Alton; Alexander M Friedman Journal: J Matern Fetal Neonatal Med Date: 2020-03-11