Journal of Obstetrics & Gynaecology   Publisher:  Taylor & Francis   Issue:  
Volume 25, Number 5 / July 2005   Pages:  462 - 464   URL:  Linking 
<http://journalsonline.tandf.co.uk/%28a0anjt55lj5eqq45gdgc4dfy%29/app/home/linking.asp?referrer=linking&target=contribution&id=M7633N7UV3130772&backto=contribution,1,1;issue,11,42;journal,12,75;linkingpublicationresults,1:100389,1;>
  Options   DOI:  10.1080/01443610500160261

Group B streptococcus disease in neonates: To screen or not to screen?

O. Subair A1, P. Wagner , F. Omojole , H. Morgan 

A Department of Obstetrics and Gynaecology, Whittington Hospital, London, UK

Abstract: 

Summary

An audit was undertaken of the prevention of early-onset Group B streptococcus 
(EOGBS) disease in neonates. The prevention strategy in use involved offering 
Intra-partum Antibiotic Prophylaxis (IAP) to mothers with identified risk 
factors, which include maternal fever in labour &gt; 38°C, previous baby with 
GBS disease, prolonged rupture of membranes &gt; 18 h, pre-term labour, GBS 
urinary tract infection and known GBS carriage. The most common risk factor 
identified was GBS carriage (41%) which was known ante-partum but logistical 
problems prevented these mothers from receiving adequate prophylaxis 4 h before 
delivery and so were classified as at risk of GBS disease. We found an 
incidence of GBS in our unit of 0.55 per 1,000 births over the study period. 
One neonate developed EOGBS disease and the mother had no identifiable risk 
factor ante-partum/intra-partum. Recent recommendations from the Royal College 
of Obstetricians and Gynaecologists (RCOG) could reduce the number of babies 
having sepsis screens performed as the time interval from beginning IAP to 
delivery has been shortened to 2 h and routine surface cultures or blood 
cultures are not recommended in well newborns. The evidence is lacking at this 
point to recommend universal screening for GBS in all pregnant women but 
patients are increasingly aware of this option and may request anogenital swabs 
to assess GBS carriage.

 

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