Prevention of neonatal group B streptococcal infections

2014 ◽  
Vol 63 (6) ◽  
pp. 4-14 ◽  
Author(s):  
Elena Vasilyevna Shipitsyna ◽  
Alevtina Mikhailovna Savicheva
Keyword(s):  
High Risk ◽  
Antibiotic Prophylaxis ◽  
Pregnant Women ◽  
Early Onset ◽  
Universal Screening ◽  
Late Onset ◽  
Late Pregnancy ◽  
Streptococcal Infections ◽  
Neonatal Group ◽  
Group B

Group B streptococcal infections (GBS) are the leading cause of sepsis, pneumonia and meningitis in infants during the first three months of life. GBS infections presenting within the first week of life are designated early-onset diseases, and those affecting infants between one week and three months - late-onset diseases. Intrapartum intravenous administration of antibiotics to women at high risk of transmitting the microorganism to the infants is currently considered the most effective method of prevention of early-onset GBS infections, and universal screening for GBS in late pregnancy - as the most effective method to detect women to whom antibiotic prophylaxis is indicated. Vaccination of pregnant women appears to be a promising approach to prevent both early- and late-onset GBS infections in infants, as well as GBS-associated diseases in women.

Early-onset neonatal group B streptococcal infections in New Zealand 1998−1999

2002 ◽  
Vol 38 (3) ◽  
pp. 272-277 ◽  
Author(s):  
K Grimwood ◽  
BA Darlow ◽  
IA Gosling ◽  
R Green ◽  
DR Lennon ◽  
...  
Keyword(s):  
New Zealand ◽  
Early Onset ◽  
Streptococcal Infections ◽  
Neonatal Group ◽  
Group B

Group B Streptococcus

1986 ◽  
Vol 7 (S2) ◽  
pp. 135-137 ◽  
Author(s):  
Charles S.F. Easmon
Keyword(s):  
United States ◽  
Early Onset ◽  
Western Europe ◽  
Late Onset ◽  
Group B Streptococcus ◽  
The United States ◽  
Group B Streptococci ◽  
Neonatal Group ◽  
Group B ◽  
Portal Of Entry

Over the past 25 years group B streptococci have become established as one of the main bacterial pathogens of the neonate in Western Europe and the United States. The attack rate of 0.25/1,000 live births found by Mayon White in Great Britain1 appears typical of many European countries. However, in some centers in the United States attack rates can be over 10 times higher.Two types of neonatal group B streptococcus (GBS) diseases exist, “early” and “late” onset. Early onset disease usually presents within the first few days of life. Often the most serious infections are present at birth or seen within a few hours. Early onset disease presents with pneumonia, respiratory distress and shock. Bacteremia is normally present and meningitis may occur. Mortality is high (50% to 75%). The portal of entry is probably the respiratory tract. Infants normally acquire the infecting organism from their mothers. Heavy maternal and infant colonization, prolonged rupture of membranes, prematurity, and obstetric complications are all risk factors.Delayed onset disease, as its name suggests, presents after the first week of life, primarily with bacteremia and meningitis. Mortality is much lower than for the early onset form, but still appreciable for a bacterial infection (14% to 18%). Its epidemiology is uncertain.

scholarly journals RISK FACTORS IN EARLY-ONSET NEONATAL GROUP B STREPTOCOCCAL INFECTIONS

1977 ◽  
Vol 11 (4) ◽  
pp. 507-507
Author(s):  
Prudence Stewardson-Krieger ◽  
Samuel P Gotoff
Keyword(s):  
Risk Factors ◽  
Early Onset ◽  
Streptococcal Infections ◽  
Neonatal Group ◽  
Group B

scholarly journals Prevention of neonatal group B streptococcal sepsis in Hungary in 2012. Preliminary data of a nation-wide survey

2014 ◽  
Vol 155 (29) ◽  
pp. 1167-1172
Author(s):  
István Sziller ◽  
Miklós Szabó ◽  
Andrea Valek ◽  
Barbara Rigó ◽  
Nándor Ács
Keyword(s):  
Public Health ◽  
Pregnant Women ◽  
Early Onset ◽  
Obstetric Care ◽  
International Standards ◽  
Preventive Strategy ◽  
Streptococcal Disease ◽  
Neonatal Group ◽  
Group B Streptococcal Disease ◽  
Group B

Introduction: At present, there is no obligatory guideline for the prevention of early-onset neonatal group B streptococcal disease in Hungary. Aim: The aim of the present study was to gain insight into the spontaneously developed preventive strategy of the domestic obstetric divisions and departments in Hungary. Method: Standardized questionnaire was sent out to each of the 71 obstetric divisions and departments in Hungary. Results: Overall, 20 (27.4%) of the chairpersons replied, and thus, 39.9% of the total number of live births in Hungary were included in the study. Despite missing public health guidelines, each of the divisions and departments developed their own strategy to prevent neonatal group B streptococcal disease. In 95% of cases, bacterial culture of the lower vagina was the method of identifying pregnant women at risk. In 5% of the cases intrapartum antibiotic prophylaxis was based on risk assessment only. Of the departments using culture-based prophylaxis, 58% departments sampled women after completion of 36th gestational weeks. Antibiotic of choice was penicillin or ampicillin in 100% of cases. Of the study participants, 80% reported on multiple administration of colonized pregnant women after onset of labor or rupture of the membranes. Conclusions: The authors concluded that the rate of participation in the study was low. However, prevention of early-onset neonatal group B streptococcal infection is a priority of obstetric care in Hungary. Lack of a nation-wide public health policy did not prevent obstetric institutions in this country to develop their own prevention strategy. In the majority of cases and institutions, the policy is consistent with the widely accepted international standards. Orv. Hetil., 2014, 155(29), 1167–1172.

Guidelines for Prevention of Group B Streptococcal (GBS) Infection by Chemoprophylaxis

PEDIATRICS ◽  
1992 ◽  
Vol 90 (5) ◽  
pp. 775-778 ◽  
Author(s):  
Keyword(s):  
Pregnant Women ◽  
Early Onset ◽  
Late Onset ◽  
The United States ◽  
Geographic Region ◽  
Culture Methods ◽  
Term Infants ◽  
Mortality And Morbidity ◽  
Young Infants ◽  
Group B

BACKGROUND For two decades streptococci classified serologically as Lancefield group B Streptococcus agalactiae (GBS) have been a leading cause of perinatal infections. In neonates and young infants these infections include congenital pneumonia, sepsis, or meningitis; in pregnant women they include urinary tract infection, chorioamnionitis, early postpartum endometritis, postcesarean section febrile morbidity, and—less frequently—pelvic thrombophlebitis or endocarditis. Although the incidence varies somewhat by geographic region, 12 000 infants and 50 000 pregnant women in the United States are estimated to develop GBS-associated morbidity or mortality annually.1 Overall mortality for early-onset (less than 7 days of age) and late-onset (7 days to 3 months of age) infant disease is approximately 15% and 10%, respectively.2-4 Gestational age significantly correlates with mortality among early-onset cases and is approximately 25% to 30% in preterm infants and 2% to 8% in term infants. Thus, every year approximately 1 600 infants die and an equal number have permanent neurologic sequelae following meningitis.1 This substantial GBS-associated perinatal mortality and morbidity make prevention strategies imperative. Among proposed strategies, including chemoprophylaxis and immunoprophylaxis, only intrapartum maternal chemoprophylaxis has been evaluated for safety and efficacy. EPIDEMIOLOGY GBS are frequently harbored in the genitourinary and lower gastrointestinal tracts of adults. When sensitive culture methods are used for their detection (ie, antibiotic-containing or selective broth media) and both lower vaginal and anorectal sites are sampled, GBS are found in 15% to 40% of pregnant women.5-8 Direct plating of swabs from body surfaces onto solid media or sampling of the cervix as a single genital tract site fails to identify as many as 50% of women who are culture-positive for GBS.4

scholarly journals Intrapartum Group B Streptococcus Antibiotic Prophylaxis in Penicillin Allergic Pregnant Women

2019 ◽  
Vol 09 (03) ◽  
pp. e238-e243 ◽  
Author(s):  
Nerlyne Desravines ◽  
Kartik K. Venkatesh ◽  
Austin Hopkins ◽  
Jamie Waldron ◽  
Megan Grant ◽  
...  
Keyword(s):  
High Risk ◽  
Allergic Reaction ◽  
Antibiotic Prophylaxis ◽  
Pregnant Women ◽  
Group B Streptococcus ◽  
Antibiotic Use ◽  
Low Risk ◽  
Antibiotic Administration ◽  
Group B ◽  
Alternative Antibiotic

Objectives To estimate the prevalence of and identify modifiable risk factors for alternative antibiotics for group B Streptococcus (GBS) prophylaxis in penicillin-allergic women. Methods Retrospective cohort study of pregnant women within a health care network from January 1, 2014, to December 31, 2017. Included women were GBS colonized, delivered at ≥ 37 weeks' gestation, and reported penicillin/cephalosporin allergy. The primary outcome was the use of alternate antibiotics GBS prophylaxis, defined per Centers for Disease Control and Prevention guidelines as antibiotics other than penicillin, ampicillin, or cefazolin. Results We identified 190 GBS-colonized pregnant women self-reporting a penicillin/cephalosporin allergy; 5% reported anaphylaxis, 44% high-risk symptoms (isolated hives, shortness of breath, swelling, or vomiting), and 51% low-risk symptoms (isolated rash, itching, or nausea). Two-thirds (63%) had alternative antibiotic prophylaxis. In adjusted analyses, nonwhite race (adjusted odds ratio [aOR]: 2.42; 95% confidence interval [CI]: 1.19–4.94) and high-risk allergic reaction (aOR: 2.42; 95% CI: 1.30–4.49) were associated with higher odds of alternative antibiotics prophylaxis compared with low-risk allergic reaction. Low-risk allergic reaction group was less likely to receive alternative antibiotic prophylaxis (aOR: 0.36; 95 CI%: 0.19–0.66). Conclusion Alternative antibiotic use for GBS prophylaxis is frequent with penicillin/cephalosporin allergies. Efforts to confirm allergy and perform penicillin hypersensitivity testing may increase compliance with guidelines for antibiotic administration.

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