To evaluate the significance of septic work-up and prophylactic antibiotics in term and preterm infants born to mothers with prolonged rupture of membranes (PROM), we carried out study on 122 cases of neonates with PROM who had been bom at
Chonnam
University Hospital during the period from January 1992 to April 1993.
They were classified into preterm infants without chorioamnionitis (A1:76), term infants without chorioamnionitis (A2: 38), preterm infants with chorioamnionitis (B1: 6) and term infants with chorioamnionitis (B2: 2).
@ES the following results were obtained:
@EN 1. The incidence of PROM was 8.3%
2. There were no significant differences between neonates without chorioamnionitis and with chorioamnionitis in the rates of symptoms suspected infections, septic work-up and its positivity, and prophylactic antibiotic therapy.
3. In neonates without chorioamnionitis, the rates of symptoms suspected infections (p<.001), of screening test and culture test (p<.001) and of prophylactic antibiotic therapy (p<.05) in the preterm infants were significantly higher than those
of
term
infants.
4. In spite of prophylactic antibiotics, the rate of neonatal infections was high (20.0% vs 16.7%)and common microorganisms were Enterobacter cloaca, S. aureus and Acinetobacter.
5. From the above results, we conclude that the prematurity and chorioamnionitis ars important risk factors for neonatal infections. And the high incidence of neonatal infections in neonates with prophylactic antibiotics suggest that the
pathogens
are
resistant to antimicrobial agents used empirically.
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