Health
Thursday, August 24, 2006
 
Group B strep infections can be fatal in newborns

By Dr. Anthony Policastro
Nanticoke Memorial Hospital
Medical Director

Recently I wrote about Group A strep. That is the bacteria that causes sore throats. There are other kinds of strep infections. One of those is known as Group B strep. Group B strep can cause infections in newborn infants. For this reason, we check pregnant women for the presence of this bacteria between 35 and 37 weeks of pregnancy. About one out of four women have a positive test. If the test is negative, then no further action is needed. If the test is positive, then that puts the infant at risk of infection. The risk of infection is not high. Only one infant of every 100 mothers who has strep will actually get an infection. Therefore, having the bacteria means there are 99 chances out of 100 that there will be no infection. The problem that does occur is in the one infant out of 100 who gets an infection. Those infections are very serious. They can be fatal. In order to prevent that infection, the mother receives antibiotics when she comes in to deliver. If she delivers more than four hours after receiving the first dose of antibiotics, the risk of infection is even lower than the one out of 100. For that reason, we watch those babies to see if they have any signs of infection. We do not do any tests on them unless there are symptoms of infection. In a newborn, the symptoms are not always clear. The temperature may be a little lower than normal. The temperature may be high. However, newborns do not tend to get fevers. They may breathe fast. They may eat poorly. Those symptoms are sometimes tricky to identify. If they show signs of infection, we do blood tests. Then we give them antibiotics for 48 hours. That is to allow the blood to grow in an incubator in the laboratory. If they have an infection, it will grow out in that time. If there are no signs of infection, they usually can be discharged at the normal time for newborns. If she delivers quickly and there is not a four-hour period, then the risk of infection is one in 100. For this reason, we obtain blood tests to send to the lab. If the infant has symptoms, we treat with antibiotics. If the blood tests look like there is an infection we treat with antibiotics. About 85 percent of the infants who develop an infection will show signs of it in the first 24 hours. The other 15 percent will show signs of it in the second 24 hours. For this reason, even in children who do not have symptoms or abnormal blood tests, we observe them for 48 hours. This is probably being overcautious. There is only one chance in 100 that an infant without four hours of antibiotics will get infected. Of that group 85 percent will have symptoms of infection in the first 24 hours. Only 15 percent will have symptoms in the second 24 hours. Fifteen percent times one out of 100 is about one in 1,000. So it works something like this. A woman has a positive culture for Group B strep. She does not get four hours of antibiotics prior to delivery. Her infant is doing well at 24 hours of age. There is a one in 1,000 chance of the infant showing signs of infection between 24 and 48 hours. The recommendation is that the infant stays in the hospital for that second 24-hour period. That recommendation is because of the serious nature of the infection. Many mothers want to go home after a 24-hour stay. In these situations, the risk is one in 1,000 that the infant has a serious disease. Some mothers will feel that risk is low and want to go home. Others may feel that since the infection is a serious one, they should stay. The recommendation is that they stay. However, you need to know the facts to make an informed decision.

Nanticoke hosting two fundraising events
On Saturday, Sept. 30, "Pumping Up The Volume" concert will be held at the Seaford Middle School auditorium. The vocal talents of Nanticoke employees and their families are sure to entertain the crowd with sounds of Country, Rock 'N Roll, Contemporary Christian and Classical music. There will be music for everyone. Emcee for the evening will be WBOC's Jimmy Hoppa. Cost is $20 for admission. Tickets are available by calling the hospital at 302-629-6611, ext. 2550 or via email at Millerl@nanticoke.org. The second fundraiser will be a bingo on Thursday, Oct. 5, starting at 7 p.m. at the Seaford Moose, located on Rt. 13A in Seaford. The evening will consist of 20 games and will feature several baskets Longaberger products as prizes. Advance tickets are $20 per person, $25 at the door. Advance ticket includes a chance to win the large hamper and the autumn treats set with wrought iron legs or one of the several door prizes. Nearly 30 chances to win. Refreshments will be available. For ticket information contact the hospital at 629-6611, ext. 2404, or via email at MorrisR@nanticoke.org. All proceeds for the two events will be donated the American Heart Association Heart Walk 2006. The AHA Heart Walk is the signature fund-raising event for the American Heart Association and the Heart Walk promotes physical activity and heart-healthy living in a fun family environment. This year more than one million walkers will participate in more than 600 events across the country, raising funds to save lives from this country's No. 1 and No. 3 killers, heart disease and stroke.

Nanticoke Memorial welcomes Dr. Ivanov
Nanticoke Memorial Hospital has added another physician to its medical staff. Dr. Monique Ivanov, board certified in internal medicine, has opened a practice at 701 Middleford Road, suite 200, Seaford. She is currently accepting new patients. Dr. Ivanov graduated from New York Medical College in Valhalla, N.Y., and completed her residency at Cabrini Medical Center in New York. She brings to Nanticoke experience in diabetes care management, women's health issues, substance abuse and is certified in acute care and intensive care unit procedures. In addition she is fluent in Spanish and French. Since April Dr. Ivanov has been working with Nanticoke's in-patient physicians.

Fit Fest September 9 at Delaware Tech
Delaware Technical & Community College, Georgetown, will have a free, family-oriented health and fitness event underwritten by a grant from Carl M. Freeman Foundation. Professional staff from Bayhealth Medical Center, Beebe Medical Center, and Nanticoke Health Services will do personal adult health screenings for blood pressure, cholesterol, glucose, and bone density. Fitness activities for children and adults; health exhibits and information available on health-related topics. Prizes, awards, freebies; food available for purchase. Rain or shine. The date is Saturday, Sept. 9, from 10 a.m. to 3 p.m.

Alzheimer's Association Memory Walk
The Alzhemier's Association, Delaware Valley Chapter, will be hosting the 2006 Memory Walk on Saturday, Sept. 30, in Rehoboth Beach. The walk will begin at 10 a.m. from Grove Park, with registration starting at 8:30 a.m. Alzhemier's disease affects more that 4.5-million Americans of every race, gender and culture. Up to 16-million American's will have the disease within 50 years, unless we find a way to stop it. The Chapter offers free programs and services to approximately 288,000 individuals with Alzheimer's or related dementia, and their caregivers, in the tri-state region. Put your best foot forward and join us for Memory Walk 2006. To support the Memory Walk 2006 register online at www.alz-delawarevalley.org, or for more information contact the local office in Georgetown at (302) 854-9788.

Medical Career Training available at Sussex Tech
The Sussex Tech Adult Division, a leading provider of healthcare workers in Sussex County and neighboring Maryland counties, is offering a number of medical training courses this fall. Daytime, as well as nighttime classes, are available. Courses are being offered include Pharmacy Technician, Medical Administrative Technician, Medical Assisting, Medical Billing and Coding Specialist, and Phlebotomy Technician. A Delaware State approved Nurse's Assistant class is also being offered. New programs this year include Physical Therapy Aide and Medical Admissions Clerk. Some of the programs being offered are approved by the National Healthcareer Association. Students may opt to take the state or nationally certifying examination. Students completing many of these courses have been extremely successful in securing job placements throughout Sussex County and the Eastern Shore of Maryland. Call 856-9035 for more information or contact the Sussex Tech Adult Division on the internet at www.SussexTechTraining.net.