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August 1984

Late-Onset Group B Streptococcal Disease After Peripartum Ampicillin Prophylaxis

Author Affiliations

Division of Infectious Diseases Berkshire Medical Center Pittsfield, MA 01201; Division of Infectious Diseases Department of Medicine and Pediatrics University of Massachusetts Medical Center Worcester, MA 01605

Am J Dis Child. 1984;138(8):795. doi:10.1001/archpedi.1984.02140460085031

Sir.—We report a recent episode of late-onset group B streptococcal (GBS) sepsis in a child following vigorous attempts at prophylaxis for known maternal vaginal colonization.

Report of a Case.—The neonate was the normal 3,000-g product of a 41-week pregnancy with vaginal delivery 2½ hours after the spontaneous rupture of the membranes. At seven months' gestation GBS had been isolated from the mother's cervix and treated with seven days of oral ampicillin sodium, 2 g/day. Reculture in the ninth month of pregnancy was negative for GBS. Shortly prior to delivery, the mother was given 1 g of ampicillin sodium intravenously. Postpartum cultures of the cervix and placenta were negative for Streptococcus. At birth, the neonate was meconium-stained, and the urine, ear canal, blood, spinal fluid, and gastric contents were cultured. Ampicillin and gentamicin sulfate administration was begun empirically. The neonate exhibited no signs of sepsis in the first 48

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