Epidemiology and predictive values of risk factors for neonatal group B streptococcal sepsis

Gilbert, G. L.; Hewitt, MC; Turner, Caroline; Leeder, Steve

doi:10.1111/j.0004-8666.2002.00497.x

Cited by 26 publications

(33 citation statements)

References 24 publications

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“…13,20 The dominant pathogen in sepsis among term neonates is GBS, accounting for 59% of term cases in one report. 21 The rate of women with rupture of membranes 18 hours or longer in our population (10.9%) was comparable with the rates reported by others, ranging from 7.8% to 12.0%, 6,9,13,22 although these populations included preterm births, which were excluded in our analysis.…”

Section: Discussionsupporting

confidence: 89%

Time Between Membrane Rupture and Delivery and Septicemia in Term Neonates

Herbst¹,

Källén

2007

Obstetrics &Amp; Gynecology

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Section: Discussionsupporting

confidence: 89%

Time Between Membrane Rupture and Delivery and Septicemia in Term Neonates

Herbst¹,

Källén

2007

Obstetrics &Amp; Gynecology

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“…Vaginal colonisation occurs in 11–30% of all pregnant women [4-6] and 50–75% of their infants become colonised usually during labour or birth. There is clear evidence that intrapartum colonisation is strongly associated with EOGBS sepsis [7] which has a case-fatality of approximately 4%[1].…”

Section: Introductionmentioning

confidence: 99%

Antenatal screening for Group B Streptococcus: A diagnostic cohort study

Hiller

McDonald

Darbyshire

et al. 2005

BMC Pregnancy Childbirth

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BackgroundA range of strategies have been adopted to prevent early onset Group B Streptococcal (EOGBS) sepsis, as a consequence of Group B Streptococcal (GBS) vertically acquired infection. This study was designed to provide a scientific basis for optimum timing and method of GBS screening in an Australian setting, to determine whether screening for GBS infection at 35–37 weeks gestation has better predictive values for colonisation at birth than screening at 31–33 weeks, to examine the test characteristics of a risk factor strategy and to determine the test characteristics of low vaginal swabs alone compared with a combination of perianal plus low vaginal swabs per colonisation during labour.MethodsConsented women received vaginal and perianal swabs at 31–33 weeks gestation, 35–38 weeks gestation and during labour. Swabs were cultured on layered horse blood agar and inoculated into selective broth prior to analysis. Test characteristics were calculated with exact confidence intervals for a high risk strategy and for antenatal screening at 31–33 and 35–37 weeks gestation for vaginal cultures alone, perianal cultures alone and combined low vaginal and perianal cultures.ResultsThe high risk strategy was not informative in predicting GBS status during labour. There is an unequivocal benefit for the identification of women colonised with GBS during labour associated with delaying screening until 36 weeks however the results for method of screening were less definitive with no clear advantage in using a combined low vaginal and perianal swabbing regimen over the use of a low vaginal swab alone.ConclusionThis study can contribute to the development of prevention strategies in that it provides clear evidence for optimal timing of swabs. The addition of a perianal swab does not confer clear benefit. The quantification of advantages and disadvantages provided in this study will facilitate communication with clinicians and pregnant women alike.

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“…Furthermore, a survey of Australian obstetricians and neonatologists found that 44% preferred a risk‐based approach 30 . Advocates for risk‐based policies indicate concerns over rare but potentially serious anaphylactic reactions to antibiotics, the risk of developing antibiotic resistance, results of health economic analyses, difficulties with obtaining timely recto‐vaginal samples and laboratories employing suboptimal culture techniques 11,31,32 . It is estimated within Australia that 30–35% of all women in labour would receive IAP under a universal screening strategy, whereas a risk‐based approach would mean only 15–20% being exposed to antibiotics 20,31 …”

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confidence: 99%

Prevention of neonatal group B streptococcus disease in the 21st century

Clifford

Garland

Grimwood

2011

J Paediatrics Child Health

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There have been significant reductions in early-onset neonatal group B streptococcus (GBS) disease following implementation of maternal intrapartum antibiotic prophylaxis (IAP) policies. Nevertheless, GBS remains a leading cause of neonatal sepsis in Australia and New Zealand resulting in considerable morbidity and mortality, particularly among preterm infants. In the United States, the universal screening-based approach for identifying women for IAP results in apparently lower rates of early-onset neonatal GBS infection than risk-based assessment. In addition, IAP has altered the profile of newborn infants who develop early-onset disease. Many affected infants lack the typical intrapartum risk factors for GBS infection, are born to mothers with a negative GBS screen or represent missed opportunities for prevention. Clinicians should remain alert for signs of sepsis in any newborn infant. We provide an update of GBS preventative management strategies in the perinatal period taking into account recent United States, Australian and New Zealand guidelines.

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Epidemiology and predictive values of risk factors for neonatal group B streptococcal sepsis

Cited by 26 publications

References 24 publications

Time Between Membrane Rupture and Delivery and Septicemia in Term Neonates

Time Between Membrane Rupture and Delivery and Septicemia in Term Neonates

Antenatal screening for Group B Streptococcus: A diagnostic cohort study

Prevention of neonatal group B streptococcus disease in the 21st century

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