Prevention of Perinatal Group B Streptococcus Infections

Abstract

Group B streptococcus (GBS) is a leading cause of neonatal infection. Maternal vaginal-rectal colonization with GBS during the intrapartum period is a prerequisite for GBS early-onset disease (EOD). The obstetric measures for effective prevention of GBS EOD include universal prenatal screening by vaginal-rectal culture, correct specimen collection and processing, appropriate implementation of intrapartum antibiotic prophylaxis, and coordination with pediatric care providers. It is now recommended to universal screen GBS between 360/7 and 376/7 weeks of gestation and to identify groups of women who are eligible for intravenous intrapartum antibiotic prophylaxis as a means of preventing GBS EOD.

Maternal Group B Streptococcal Rectovaginal Colonization after Intrapartum Antibiotic Prophylaxis

“…The specimens were transferred into a selective enrichment broth and incubated for 24–48 h at 37 °C in 5% CO 2 and then transferred to a blood agar plate for subculture. After an overnight incubation period, the plates were analyzed for GBS colonies [ 3 ].…”

“…Group B Streptococcus (GBS), or Streptococcus agalactiae, is a Gram-positive bacterium that colonizes 11–35% of pregnant women at vaginal/rectal sites [ 1 ]. Maternal GBS colonization is an important risk factor for perinatal infection in neonates [ 2 , 3 ]. Invasive GBS disease (0.41 per 1000 live births) is associated with a high mortality rate of almost 50% in newborn infants [ 2 , 3 ].…”

“…Maternal GBS colonization is an important risk factor for perinatal infection in neonates [ 2 , 3 ]. Invasive GBS disease (0.41 per 1000 live births) is associated with a high mortality rate of almost 50% in newborn infants [ 2 , 3 ]. Infant survivors of invasive GBS sepsis had 3.5-fold greater odds of neurological impairment by 1 year of age [ 4 ].…”

“…Infant survivors of invasive GBS sepsis had 3.5-fold greater odds of neurological impairment by 1 year of age [ 4 ]. GBS may also cause maternal urinary tract infection, intraamniotic infection or endometritis and is associated with preterm labor and stillbirth [ 3 , 5 , 6 , 7 , 8 ].…”

“…Universal screening for GBS in late pregnancy and providing intrapartum antibiotic prophylaxis (IAP) for GBS carriers to prevent neonatal GBS infection are recommended by international societies [ 2 , 3 ]. The first-line antimicrobial prophylaxis against GBS infection is penicillin or amoxicillin, which have been deemed equally effective [ 2 ].…”