scholarly journals Predischarge Postpartum Methicillin ResistantStaphylococcus aureusInfection and Group B Streptococcus Carriage at the Individual and Hospital Levels

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Andrea M. Parriott ◽  
Joelle M. Brown ◽  
Onyebuchi A. Arah
Keyword(s):  
United States ◽  
Odds Ratio ◽  
Group B Streptococcus ◽  
Geographic Region ◽  
Hierarchical Regression ◽  
Covariate Data ◽  
Odds Ratio Estimate ◽  
Mrsa Infection ◽  
Group B ◽  
The Individual

Background. We sought to characterize the relationship between individual group B streptococcus (GBS) colonization and pre-discharge postpartum methicillin resistantStaphylococcus aureus(MRSA) infection in United States women delivering at term. We also sought to examine the association between hospital GBS colonization prevalence and MRSA infection.Materials and Methods. Data was from the Nationwide Inpatient Sample, a representative sample of United States community hospitals. Hierarchical regression models were used to estimate odds ratios adjusted for patient age, race, expected payer, and prepregnancy diabetes and hospital teaching status, urbanicity, ownership, size, and geographic region. We used multiple imputation for missing covariate data.Results. There were 3,136,595 deliveries and 462 cases of MRSA infection included in this study. The odds ratio for individual GBS colonization was 1.2 (95% confidence interval: 0.9 to 1.5). For a five-percent increase in the hospital prevalence of GBS colonization, the odds ratio was 0.9 (95% CI: 0.1 to 5.6).Conclusions. The odds ratio estimate for the association of hospital GBS prevalence with MRSA infection is too imprecise to make conclusions about its magnitude and direction. Barring major bias in our estimates, individual GBS carriage does not appear to be strongly associated with predischarge postpartum MRSA infection.

Group B Streptococcus

1986 ◽  
Vol 7 (S2) ◽  
pp. 135-137 ◽  
Author(s):  
Charles S.F. Easmon
Keyword(s):  
United States ◽  
Early Onset ◽  
Western Europe ◽  
Late Onset ◽  
Group B Streptococcus ◽  
The United States ◽  
Group B Streptococci ◽  
Neonatal Group ◽  
Group B ◽  
Portal Of Entry

Over the past 25 years group B streptococci have become established as one of the main bacterial pathogens of the neonate in Western Europe and the United States. The attack rate of 0.25/1,000 live births found by Mayon White in Great Britain1 appears typical of many European countries. However, in some centers in the United States attack rates can be over 10 times higher.Two types of neonatal group B streptococcus (GBS) diseases exist, “early” and “late” onset. Early onset disease usually presents within the first few days of life. Often the most serious infections are present at birth or seen within a few hours. Early onset disease presents with pneumonia, respiratory distress and shock. Bacteremia is normally present and meningitis may occur. Mortality is high (50% to 75%). The portal of entry is probably the respiratory tract. Infants normally acquire the infecting organism from their mothers. Heavy maternal and infant colonization, prolonged rupture of membranes, prematurity, and obstetric complications are all risk factors.Delayed onset disease, as its name suggests, presents after the first week of life, primarily with bacteremia and meningitis. Mortality is much lower than for the early onset form, but still appreciable for a bacterial infection (14% to 18%). Its epidemiology is uncertain.

scholarly journals Clonal Analysis of Colonizing Group B Streptococcus, Serotype IV, an Emerging Pathogen in the United States

2010 ◽  
Vol 48 (9) ◽  
pp. 3100-3104 ◽  
Author(s):  
M. J. Diedrick ◽  
A. E. Flores ◽  
S. L. Hillier ◽  
R. Creti ◽  
P. Ferrieri
Keyword(s):  
United States ◽  
Group B Streptococcus ◽  
The United States ◽  
Clonal Analysis ◽  
Emerging Pathogen ◽  
Group B

scholarly journals Invasive Group B Streptococcus Disease With Recurrence and in Multiples: Towards a Better Understanding of GBS Late-Onset Sepsis

2021 ◽  
Vol 12 ◽  
Author(s):  
Mirjam Freudenhammer ◽  
Konstantinos Karampatsas ◽  
Kirsty Le Doare ◽  
Fabian Lander ◽  
Jakob Armann ◽  
...  
Keyword(s):  
Risk Factors ◽  
Disease Risk ◽  
Late Onset ◽  
Group B Streptococcus ◽  
Retrospective Case ◽  
Late Onset Sepsis ◽  
Increased Risk ◽  
Group B ◽  
The Individual ◽  
The Uk

Group B Streptococcus (GBS) is a common intestinal colonizer during the neonatal period, but also may cause late-onset sepsis or meningitis in up to 0.5% of otherwise healthy colonized infants after day 3 of life. Transmission routes and risk factors of this late-onset form of invasive GBS disease (iGBS) are not fully understood. Cases of iGBS with recurrence (n=25) and those occurring in parallel in twins/triplets (n=32) from the UK and Ireland (national surveillance study 2014/15) and from Germany and Switzerland (retrospective case collection) were analyzed to unravel shared (in affected multiples) or fixed (in recurrent disease) risk factors for GBS disease. The risk of iGBS among infants from multiple births was high (17%), if one infant had already developed GBS disease. The interval of onset of iGBS between siblings was 4.5 days and in recurrent cases 12.5 days. Disturbances of the individual microbiome, including persistence of infectious foci are suggested e.g. by high usage of perinatal antibiotics in mothers of affected multiples, and by the association of an increased risk of recurrence with a short term of antibiotics [aOR 4.2 (1.3-14.2), P=0.02]. Identical GBS serotypes in both recurrent infections and concurrently infected multiples might indicate a failed microbiome integration of GBS strains that are generally regarded as commensals in healthy infants. The dynamics of recurrent GBS infections or concurrent infections in multiples suggest individual patterns of exposure and fluctuations in host immunity, causing failure of natural niche occupation.

Antibiotics during Intrauterine Balloon Tamponade Is Associated with a Reduction in Endometritis

2019 ◽  
Vol 36 (12) ◽  
pp. 1211-1215
Author(s):  
Melissa S. Wong ◽  
Gabriela Dellapiana ◽  
Naomi Greene ◽  
Kimberly D. Gregory
Keyword(s):  
Cohort Study ◽  
Confidence Interval ◽  
Odds Ratio ◽  
Retrospective Cohort ◽  
Mode Of Delivery ◽  
Group B Streptococcus ◽  
Prophylactic Antibiotics ◽  
Balloon Tamponade ◽  
Baseline Characteristics ◽  
Group B

Objective To evaluate whether prophylactic antibiotics at the time of placement of an intrauterine balloon tamponade (IBT) is associated with a reduction in postpartum endometritis. Study Design Retrospective cohort study of patients who received an IBT from January 1, 2012, to December 12, 2016. Patients were included if the IBT remained in place at least 2 hours and excluded if chorioamnionitis was present. Patients who received prophylactic antibiotics at the time of IBT placement were compared with those who did not. Results A total of 149 subjects received an IBT; 36 were excluded due to early removal or chorioamnionitis. Of the remaining, 59 received prophylactic antibiotics and 54 did not. Baseline characteristics were similar between the groups except mode of delivery. The majority (65%) of those who did not receive prophylactic antibiotics had a cesarean delivery (p = 0.03). The overall incidence of endometritis was 15%. The incidence of endometritis was greater among those patients who did not receive prophylactic antibiotics compared with those who did (5 vs. 26%; p < 0.002; odds ratio [OR]: 6.53; 95% confidence interval [CI]: 1.76–24.25). This association remained after adjustment for mode of delivery and receiving group B Streptococcus antibiotics prior to delivery (adjusted OR: 5.9; 95% CI: 1.58–22.35). Conclusion Prophylactic antibiotics were associated with a reduction in postpartum endometritis among patients receiving an IBT.

Power, Conflict, and Effectiveness

2000 ◽  
Vol 5 (1) ◽  
pp. 28-33 ◽  
Author(s):  
M. Afzalur Rahim ◽  
David Antonioni ◽  
Krum Krumov ◽  
Snejana Ilieva
Keyword(s):  
United States ◽  
Regression Analysis ◽  
Interpersonal Conflict ◽  
The United States ◽  
Hierarchical Regression ◽  
Hierarchical Regression Analysis ◽  
Referent Power ◽  
Legitimate Power ◽  
Power Base ◽  
Effectiveness Data

This study investigated the relationships of bases of leader power (coercive, reward, legitimate, expert, and referent) and styles of handling interpersonal conflict (integrating, obliging, dominating, avoiding, and compromising) to subordinates' effectiveness. Data for this study were collected with questionnaires from the United States and Bulgaria and analyzed with hierarchical regression analysis for each country. Results indicated that in the United States referent power base of supervisors and integrating style of handling conflict of subordinates were positively associated with effectiveness. In Bulgaria, legitimate power base of supervisors was positively associated with effectiveness, but the subordinates' conflict styles were not associated with effectiveness.

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