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

Abstract

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.

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

“…In this regard, our results are in consistence with a study in the Netherlands by Arijaan et al on 1,702 women from 72 countries (17). Despite various associated factors introduced in previous literature, including bacterial vaginosis, recent vaginal intercourse, vaginal washing (18), colonization in prior pregnancy (19), and body mass index, typical intra-partum risk factors and positive screens are lacking in many infants, who are affected with GBS infection (20). With 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.…”

Serotype distribution, antimicrobial resistance, and molecular characterization of invasive group B Streptococcus isolates recovered from Chinese neonates

“…Recently, the incidence of neonatal GBS EOD in Australia, New Zealand and the Page 6 of 20 A c c e p t e d M a n u s c r i p t 6 Unites States (US) has decreased putatively because of the implementation of intrapartum antibiotic prophylaxis (IAP) [6,7]. In developing countries such as China, however, neonatal GBS disease remains problematic and has not been adequately addressed.…”

Early‐onset neonatal group B streptococcus sepsis following national risk‐based prevention guidelines

“…Intrapartum antibiotic prophylaxis (IAP) interrupts mother‐to‐baby transmission of GBS, reducing the risk of early‐onset neonatal infection . However, different countries and jurisdictions have adopted varying recommendations as to whether IAP should be offered according to antenatal screening results for GBS carriage or by using clinical risk factors . During 1998–1999, we undertook a two‐year prospective national survey of early‐onset neonatal GBS disease (defined as infection in the first 48 h of life) in New Zealand and reported the attack rate as 0.5 per 1000 live births .…”