Current U.S. guidelines for reducing the incidence of early-onset group B streptococcal disease in neonates recommend either screening pregnant women for infection or using the presence of clinical risk factors to identify candidates for intrapartum antibiotic prophylaxis. This multicenter, retrospective study compared the rates of early-onset group B streptococcal disease among infants born to mothers who had a documented culture for group B streptococcus during pregnancy (screened group) and those born to women with no screening documented (presumed “risk-based” group). The risk of early-onset disease in the screened group was half that in the risk-based group. Potential misclassification in the risk-based group of women whose providers had no defined strategy did not explain the observed results, since the lower risk persisted after the exclusion of women who had clinical risk factors warranting prophylaxis but did not receive it.

In this study, to assess whether the increasing use of intrapartum antibiotics to reduce neonatal group B streptococcal infection has been associated with changes in the rate and causes of early-onset sepsis in very-low-birth-weight infants, the authors compared the incidence of early-onset sepsis (that occurring within 72 hours of birth) among infants weighing 401 to 1500 g who were born between 1998 and 2000 with an earlier cohort of very-low-birth-weight infants born between 1991 and 1993. As compared with the 1991–1993 cohort, there was a marked reduction in group B streptococcal sepsis in the 1998–2000 cohort but an increase in Escherichia coli sepsis, such that the overall rate of early-onset sepsis was not significantly changed. Infants with early-onset sepsis were more likely to die than uninfected infants.

The shortage of renal allografts has led to interest in sources of organs other than living donors and cadaveric donors with a heartbeat. Accumulating data suggest that the short-term survival of cadaveric kidneys from donors without a heartbeat is similar to that of kidneys from donors with a heartbeat. This report describes a single-center study of 122 patients who received kidney transplants from donors without a heartbeat and 122 matched patients who received transplants from donors with a heartbeat. Recipients were followed for up to 15 years. Although there was a significantly higher incidence of initial delay in graft function among those who received kidneys from donors without a heartbeat, long-term graft survival was similar in the two groups.

In utero surgery for myelomeningocele has been proposed to reduce neurologic dysfunction that may result from exposure of the spinal cord to amniotic fluid; approximately 220 such surgeries have been performed to date. The authors report on three girls under one year of age who had loss of motor function in the legs or loss of bladder function after in utero repair of myelomeningocele at 22 to 24 weeks of gestation. All three had dermoid cysts with associated spinal cord tethering, which required surgery.