IDENTIFICATION OF SEPSIS IN NEONATES FOLLOWING MATERNAL ANTIBIOTIC-THERAPY

To examine the value of current diagnostic tests identifying neonatal sepsis related to intrapartum treatment with antibiotics, we reviewed the charts of 219 mother-infant pairs, of which 139 mothers received intrapartum antibiotics (group 1) and 80 mothers did not (group 2). When compared with group 2 infants, group 1 infants had fewer positive blood cultures (4.3% vs 20%, P<0.003), blood cultures positive for group B streptococci (GBS) (P<0.001), and positive urine GBS latex agglutination (LA) tests (P <0.001). Although the sensitivity of the white blood cell count (WBC) was 81%, the specificity was <60% in both groups. The specificity of the urine GBS LA test was 92%. These results suggest (1) the WBC will neither confirm nor rule out neonatal septicemia; (2) blood cultures are indicated in suspected neonatal sepsis even if there was maternal intrapartum treatment with antibiotics; and (3) a urine GBS LA test is a useful adjunct in the diagnosis of neonatal GBS septicemia.