Factors associated with choice of approach for Group B streptococcus screening

Abstract

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.

Group B Streptococcus serotypes associated with different clinical syndromes: Asymptomatic carriage in pregnant women, intrauterine fetal death, and early onset disease in the newborn

“…Increased rates of GBS EOD (0.51/1000 live births) and IUFD (3.79/1000 live births) in MHMC during 2017 led us to enhanced screening of pregnant woman before labor. We found that GBS carriage rates in MHMC were higher than the carriage rate reported in Israel (26.1% versus 6–21%, respectively) [ 4 , 24 ]. MHMC caters mostly Orthodox Jewish women.…”

Group B Streptococcus real‐time PCR may potentially reduce intrapartum maternal antibiotic treatment

“…1 Nonetheless, about 30% of pregnant women in Israel undergo GBS screening. 6 Intrapartum real-time polymerase chain reaction (PCR) has demonstrated more sensitivity and specificity for intrapartum detection of GBS colonisation than risk-factor-based detection and universal GBS culture screening at 35-37 weeks. [7][8][9] A pilot study showed that 68% of women in labour who fulfilled the risk-factor criteria were GBS negative by PCR upon admission.…”

Antimicrobial resistance and molecular characterization of Streptococcus agalactiae from pregnant women in southern China

“…Streptococcus agalactiae (group B streptococcus, GBS), a common commensal of the female genital tract, has been considered the main cause of neonatal sepsis and meningitis and as the most common agent of invasive infections in pregnant women [1]. According to the previous studies in different countries, approximately 10.00%-31.50% of pregnant women are vaginally and/or rectally colonized with GBS [2][3][4][5][6]. The universal screening for maternal GBS colonization at 35 to 37 weeks' gestation and the use of intrapartum antibiotic prophylaxis have resulted in a nearly 80% reduction in the rate of neonatal GBS infection over the past 15 years, from 1.7 cases per 1,000 live births in the early 1990s to 0.34-0.37 cases per 1,000 live births in recent years [7].…”