Bacteriological findings after premature rupture of the membranes

Of 243 children born after premature rupture of the membranes (PROM) 61 (26%) had the same bacteria in placental arterial blood, in ear swabs (taken deep from the external auditory canal) and in meconium. The predominant organisms were E. coli, Bacteroides fragilis, Streptococcus faecalis (enterococci) and Streptococcus agalactiae (group B streptococci). The infection rate was only 10% if the membranes had ruptured within 24 h of the onset of labour and 30% if the interval was longer than 24 h. Of 131 children born without premature rupture of the membranes but with risk factors for sepsis 9 (7%) had a positive blood culture with the same organism in the ear swabs and in meconium. The organisms were Streptococcus agalactiae (6 cases) and E. coli, Streptococcus faecalis and Klebsiella pneumoniae (one case each). Contamination of placental blood cultures was rare.