Early‐onset group B streptococcal disease following culture‐based screening in Japan: A single center study

Abstract

Aim: We investigated trends in early-onset group B streptococcal disease (EOD) after the introduction of culture-based screening in Japan. Material and Methods: A retrospective cohort study examined EOD trends in 9506 pregnancies and 10 715 neonates at our center from 2002 to 2009. Results: EOD occurred in four neonates (4/7332: 0.55/1000 live births). The EOD incidence among infants born to women positive for GBS by screening was 0.90 cases per 1000 live births (1/1107). In contrast, the EOD incidence among infants negative by GBS screening was 0.48 cases per 1000 live births (3/6225). Thus, of the four affected neonates, three had mothers who tested negative on antepartum GBS screening. Two neonates had symptoms of infection during labor and intrapartum antibiotic agents were administered. The other two neonates received no antibiotics because deliveries were uneventful and they were negative on GBS screening. Conclusion:The incidence of EOD is 0.90 cases per 1000 live births among GBS-positive women and 0.48 cases per 1000 live births among GBS-negative women. The results of our study implied that EOD can develop regardless of GBS screening and intrapartum clinical course, although the method of sample collection, indications for antibiotic prophylaxis, and the antibiotics regimen should be considered.

Management of group b streptococcus-positive pregnant women at maternity homes in JAPAN: a questionnaire survey of compliance among midwives

“…In the present study, the rate of compliance with this guideline was very low (37.0%) and some midwives answered that they made arbitrary decisions in cases of 24 h since PROM or consulted a doctor about hospital transfer each time. Moreover, only 82.2% of midwives referred pregnant women in labour to a hospital by ambulance even though fever is an obvious sign of septic infection due to GBS [ 20 , 21 ]. In such cases, there is a high possibility of a delay in the primary treatment for EOD.…”

Emergent serious condition of the neonates associated with cerebral palsy in Japan

“…On the other hand, 50% (4/8 cases) of HTTPS://WWW.HKSMP.COM/JOURNALS/PRM the early-onset type and 25% (1/4 cases) of the late-onset type infection cases were managed without complying with the clinical practice guidelines including the use of antibacterial agents during delivery published in the USA or Japan. Based on these cases and previous studies, [17,18] it may not be possible to prevent 50% of the early-onset type infection even if the current guidelines are followed closely.…”

“…In some previous studies, more than half of early-onset GBS disease has been reported to occur in neonates born to women with negative GBS screening tests. [17,18] On the other hand, to date there have not been any preventive methods for the latter type of neonatal GBS infection.…”

Low Accuracy of Antenatal Screening for Group B Streptococcus From Perianal Area

“…GBS has been observed to be present in the bowel flora of 17.4% of adults (colonization) including pregnant women, and those who are colonized are called “carriers” [ 1 ]. To date, more than half of early-onset GBS disease has been reported to occur in neonates born to women with negative GBS screening tests [ 2 , 3 ]. For example, the recent article in Japan by Miyata et al [ 2 ] has also concerned that early-onset GBS disease can develop in infants who are born to mothers with negative GBS screening results.…”

“…To date, more than half of early-onset GBS disease has been reported to occur in neonates born to women with negative GBS screening tests [ 2 , 3 ]. For example, the recent article in Japan by Miyata et al [ 2 ] has also concerned that early-onset GBS disease can develop in infants who are born to mothers with negative GBS screening results. The timing of GBS screening at 35 - 37 weeks recommended by the Centers for Disease Control and Prevention (CDC) [ 4 ] and the American College of Obstetricians and Gynecologists (ACOG) [ 5 ] was established based on an earlier study by Yancey et al [ 6 ], which indicated that the accuracy of late antenatal anogenital cultures in predicting GBS colonization at delivery is high in cultures collected at 1 - 5 weeks before delivery.…”