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Effect of Intrapartum Antibiotic Prophylaxis Against Group B Streptococcal Infection on Comparisons of Rates of Endometritis and Urinary Tract Infection in Multicenter Surveillance

Published online by Cambridge University Press:  02 January 2015

Anne-Marie Dumas ,
Raphaëlle Girard ,
Louis Ayzac ,
Geneviève Beaumont ,
Emmanuelle Caillat-Vallet ,
Florence Depaix ,
Chantal Gignoux ,
Catherine Haond ,
Noelle Pral  and
Jacqueline Robert
...Show all authors
Anne-Marie Dumas*
Affiliation:
Service de Gynécologie Obstétrique, Saint Genis Laval, France
Raphaëlle Girard
Affiliation:
Service d'Hygiène et Épidémiologie, Centre Hospitalier Lyon Sud, Pierre Bénite, Saint Genis Laval, France
Louis Ayzac
Affiliation:
Centre de Coordination de la Lutte Contre les Infections Nosocomiales Sud-Est, Saint Genis Laval, France
Geneviève Beaumont
Affiliation:
Centre de Coordination de la Lutte Contre les Infections Nosocomiales Sud-Est, Saint Genis Laval, France
Emmanuelle Caillat-Vallet
Affiliation:
Centre de Coordination de la Lutte Contre les Infections Nosocomiales Sud-Est, Saint Genis Laval, France
Florence Depaix
Affiliation:
Centre de Coordination de la Lutte Contre les Infections Nosocomiales Sud-Est, Saint Genis Laval, France
Chantal Gignoux
Affiliation:
Centre de Coordination de la Lutte Contre les Infections Nosocomiales Sud-Est, Saint Genis Laval, France
Catherine Haond
Affiliation:
Centre de Coordination de la Lutte Contre les Infections Nosocomiales Sud-Est, Saint Genis Laval, France
Noelle Pral
Affiliation:
Centre de Coordination de la Lutte Contre les Infections Nosocomiales Sud-Est, Saint Genis Laval, France
Jacqueline Robert
Affiliation:
Centre de Coordination de la Lutte Contre les Infections Nosocomiales Sud-Est, Saint Genis Laval, France
Françoise Tissot-Guerraz
Affiliation:
Centre de Coordination de la Lutte Contre les Infections Nosocomiales Sud-Est, Saint Genis Laval, France
Agnès Vincent-Bouletreau
Affiliation:
Centre de Coordination de la Lutte Contre les Infections Nosocomiales Sud-Est, Saint Genis Laval, France
Michel Berland
Affiliation:
Service de Gynécologie Obstétrique, Saint Genis Laval, France
Jacques Fabry
Affiliation:
Centre de Coordination de la Lutte Contre les Infections Nosocomiales Sud-Est, Saint Genis Laval, France
*
Centre Hospitaller Lyon Sud, Service de Gynécologie Obstétrique, Bâtiment 3B, Pierre Bénite Cedex, 69495 Pierre Bénite, France (anne-marie.dumas@chu-lyon.fr)
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Abstract

Objective.

To establish whether antibiotic prophylaxis against group B streptococcal infection may be a confounding factor in comparisons of rates of endometritis and urinary tract infection after vaginal delivery.

Design.

Prospective study.

Setting.

Maternity units at 48 hospitals in a regional surveillance network in France during 2001-2004.

Methods.

The maternity units used a common protocol to establish whether antibiotic prophylaxis was indicated. Risk factors for endometritis and urinary tract infections were evaluated using multiple logistic regression.

Results.

We analyzed 49,786 vaginal deliveries. The percentage of women receiving antibiotic prophylaxis varied widely and significantly among the maternity units (range, 4.4%-26.0%; median, 15.8%; 25th percentile, 12.1%; 75th percentile, 19.0%) (P < .001, by Mantel-Haenszel χ2 test). The incidence rate of endometritis was significantly reduced from 0.25% to 0.11% by antibiotic prophylaxis (P = .001). There was a decrease in the incidence of urinary tract infection from 0.37% to 0.32%, but it was not statistically significant (P = .251).

Conclusions.

A reduction in the incidence of endometritis was observed when intrapartum antibiotic prophylaxis against group B streptococcal infection was used. However, the proportion of women considered to be at risk of infection varied widely among institutions. Comparisons of rates of endometritis among maternity units, but not urinary tract infection rates, should take into account antibiotic prophylaxis as a significant confounding factor.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 29 , Issue 4 , April 2008 , pp. 327 - 332
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2008

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