Culture-based versus risk-based screening for the prevention of group B streptococcal disease in newborns: A review of national guidelines

Homer, Caroline; Scarf, Vanessa; Catling, Christine; Davis, Deborah

doi:10.1016/j.wombi.2013.09.006

Cited by 34 publications

(32 citation statements)

References 26 publications

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“…The findings of the present study revealed an 11.8% GBS colonization rate among participants, almost similar to another population based study in Iran, which reported a 9.1% carrier rate (3). Worldwide reports of GBS carriage prevalence estimated a 10% to 30% rate (14). It seems that Iranian women have a relatively low prevalence of GBS colonization.…”

Section: Discussionmentioning

confidence: 99%

The prevalence and risk factors of group B streptococcus colonization in Iranian pregnant women

et al. 2017

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BackgroundGroup B Streptococcus (GBS) is a leading cause of serious neonatal infections. Although great progress has been made in preventing prenatal GBS, its colonization rate in different regions of Iran remains unknown.AimTo determine GBS colonization prevalence and its risk factors among Iranian pregnant women.MethodsThis prospective cross-sectional study was performed on 186 pregnant women, who attended Boo-Ali hospital which is affiliated with Islamic Azad University in Tehran, Iran, from March 2014 to June 2015. The demographic, obstetric and gynecological data were gathered. A recto-vaginal culture was taken from each patient, with a sterile swab, in lithotomy position without using speculum, and vaginal pH was measured. Patients with positive GBS received IV antibiotic therapy during labor (penicillin G 3 gram at first dose then 1.5 gram Q/4h until delivery). Data were analyzed by statistical software SPSS version 21. Statistical tests for differences were performed by Chi-square test. Potential confounding was assessed by logistic regression. Level of significance was set at p<0.05.ResultsTwenty-two (11.8%) patients had positive recto-vaginal colonization. No significant differences between colonized and GBS-negative women with regard to age, obstetrics history and socio-economic factor were noticed. In contrast, smoking, history of previous infection with HPV, presence of vulvitis and a vaginal pH>4.5 were associated with GBS colonization (p≤0.05).ConclusionsWith a relatively low prevalence and few significantly correlated factors, it is hardly possible to define a high risk group of pregnant women for GBS colonization. Therefore, thorough measures should be taken in order to prevent infection complications in mothers and neonates in the Iranian population.

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Section: Discussionmentioning

confidence: 99%

The prevalence and risk factors of group B streptococcus colonization in Iranian pregnant women

et al. 2017

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“…Advocates point to countries across Europe and North America where screening is recommended78910111213141516171819 and where reductions in early onset GBS infection have been observed 202122. But the evidence shows that the effectiveness of screening, using established screening criteria,23 is uncertain and that screening has potential harms.…”

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confidence: 99%

Universal antenatal screening for group B streptococcus may cause more harm than good

Seedat

Geppert

Stinton

et al. 2019

BMJ

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“…Group B Streptococcus (GBS) is a leading cause of life-threatening infection in newborns causing sepsis, pneumonia and meningitis [1]. Early onset GBS (EOGBS) occurs within the first week of life (0–6 days) [2].…”

Section: Introductionmentioning

confidence: 99%

“…Screening for women requiring IAP has been done using one of two approaches: culture-based universal screening which should be done between weeks 35 and 37 of pregnancy and risk-based approach in which women receive IAP based on the presence of risk factors [1, 4]. Universal Screening policy is practiced in the United States and Canada [1–3, 5] and it is also recommended with some modifications in many European countries and in Japan [6], (http://www.groupbstrepinternational.org/what-is-group-b-strep/early-onset-gbs-disease/), [2]. A risk-based approach is recommended in Denmark, Israel, the Netherlands, New Zealand and the United Kingdom [1, 2].…”

Section: Introductionmentioning

confidence: 99%

“…Universal Screening policy is practiced in the United States and Canada [1–3, 5] and it is also recommended with some modifications in many European countries and in Japan [6], (http://www.groupbstrepinternational.org/what-is-group-b-strep/early-onset-gbs-disease/), [2]. A risk-based approach is recommended in Denmark, Israel, the Netherlands, New Zealand and the United Kingdom [1, 2]. Prior to the introduction of preventive measures, the incidence of EOGBS ranged between 0.5 to more than 4 per 1000 live births, and the rates varied substantially among various geographical regions [2].…”

Section: Introductionmentioning

confidence: 99%

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Factors associated with choice of approach for Group B streptococcus screening

Sefty

Klivitsky

Bromberg

et al. 2016

Isr J Health Policy Res

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BackgroundThe crude rate of early-onset Group B streptococcus disease (EOGBS) in Israel has been consistently under 0.5 for 1000 live births for the past 8 years. The Israeli Ministry of Health has adapted the risk factor based approach for preventing EOGBS and universal bacteriological screening for GBS is not recommended. In spite of this policy, there are indications that many pregnant women in Israel undergo bacteriological screening for GBS.The objective of this study is to assess the rate and characteristics of pregnant women who undergo screening for group B streptococcus (GBS) colonization in Israel.MethodsSurvey of expectant mothers who came to give birth in 29 delivery rooms throughout Israel during the month of July 2012 regarding GBS screening practice and demographics.ResultsA total of 2968 pregnant women participated in the assessment. Among them, 935 women (31.5 %) had been tested for GBS colonization. About 90 % of those women had no risk factors, only 542 women (60 %) underwent testing during the recommended gestational timing (35–37 weeks) and 23 % of the tested women reported being GBS carriers.GBS screening as part of the routine pregnancy follow- up was associated with: residence district, intermediate or high socioeconomic rank, being a member of certain health maintenance organization and being Jewish.Characteristics found to be significantly associated with being a GBS carrier were: low socioeconomic rank, and having a risk factor for GBS infection.ConclusionsA substantial number of pregnant women in Israel undergo screening for GBS colonization despite the national policy against universal screening. While GBS colonization was more prevalent in women of lower socioeconomic status, screening is done more often in those of higher socioeconomic status, suggesting unnecessary monetary expenses.

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Culture-based versus risk-based screening for the prevention of group B streptococcal disease in newborns: A review of national guidelines

Cited by 34 publications

References 26 publications

The prevalence and risk factors of group B streptococcus colonization in Iranian pregnant women

The prevalence and risk factors of group B streptococcus colonization in Iranian pregnant women

Universal antenatal screening for group B streptococcus may cause more harm than good

Factors associated with choice of approach for Group B streptococcus screening

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