Timing of Group B Streptococcus Screening in Pregnancy: A Systematic Review

Berg, Arijaan W. Valkenburg-van den; Houtman-Roelofsen, Rebecca L.; Oostvogel, Paul M.; Dekker, Friedo W.; Dörr, P. Joep; Sprij, Arwen

doi:10.1159/000265942

Cited by 62 publications

(50 citation statements)

References 103 publications

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“…Although a great heterogeneity of PPVs has been described [5,6,9] ranging (43-100%), our study revealed a considerably low PPV of 24.4%. This weak concordance between prenatal and intrapartum culture results could be attributed to several variables, namely (1) timing of prenatal GBS screening; (2) laboratory methodologies; and (3) antibiotic usage.…”

Section: Discussioncontrasting

confidence: 67%

See 1 more Smart Citation

Accuracy of prenatal culture in predicting intrapartum group B streptococcus colonization status

Florindo¹,

Damião²,

Lima³

et al. 2013

The Journal of Maternal-Fetal & Neonatal Medicine

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Objective: To evaluate the positive predictive value (PPV) of group B Streptococcus (GBS) cultures at 35-37 weeks of gestation relative to GBS colonization status at delivery. Methods: Rectovaginal swabs from 221 women at labor in four Lisbon hospitals were collected for GBS screening according to the CDC guidelines. Results: The PPV was 24.4%. IAP was administered to 100% of prenatally GBS positive women. There was no case of early onset GBS disease (EOD). Conclusions: Poor accuracy of prenatal cultures in identifying true candidates for IAP highlights the need for Portuguese clinical and laboratory guidelines to prevent EOD and antibiotic overtreatment of pregnant women.

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Section: Discussioncontrasting

confidence: 67%

“…The influence of the timing of prenatal GBS screening in this study would be neglectable; in fact, all enrolled GBS positive women were screened at 35-37 weeks of gestation, which has been considered ideal for correlating with GBS colonization status at delivery, by longitudinal studies [9].…”

Section: Discussionmentioning

confidence: 99%

Accuracy of prenatal culture in predicting intrapartum group B streptococcus colonization status

Florindo¹,

Damião²,

Lima³

et al. 2013

The Journal of Maternal-Fetal & Neonatal Medicine

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“…However the expected predictive values were too optimistic. In studies evaluating antenatal culture to predict intrapartum status for genital colonization with GBS, reported sensitivities range from 51% to 87%, specificities from 93.7% to 97.1%, positive and negative predictive values from 60.6% to 87% and from 88% to 96% [77,[79][80][81][82][83][84][85][86][87].…”

Section: Timing Of Screeningmentioning

confidence: 99%

Intrapartum GBS screening and antibiotic prophylaxis: a European consensus conference

Renzo

Melin²,

Berardi

et al. 2014

The Journal of Maternal-Fetal & Neonatal Medicine

156

135

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Group B streptococcus (GBS) remains worldwide a leading cause of severe neonatal disease. Since the end of the 1990s, various strategies for prevention of the early onset neonatal disease have been implemented and have evolved. When a universal antenatal GBS screening-based strategy is used to identify women who are given an intrapartum antimicrobial prophylaxis, a substantial reduction of incidence up to 80% has been reported in the USA as in other countries including European countries. However recommendations are still a matter of debate due to challenges and controversies on how best to identify candidates for prophylaxis and to drawbacks of intrapartum administration of antibiotics. In Europe, some countries recommend either antenatal GBS screening or risk-based strategies, or any combination, and others do not have national or any other kind of guidelines for prevention of GBS perinatal disease. Furthermore, accurate population-based data of incidence of GBS neonatal disease are not available in some countries and hamper good effectiveness evaluation of prevention strategies. To facilitate a consensus towards European guidelines for the management of pregnant women in labor and during pregnancy for the prevention of GBS perinatal disease, a conference was organized in 2013 with a group of experts in neonatology, gynecologyobstetrics and clinical microbiology coming from European representative countries. The group reviewed available data, identified areas where results were suboptimal, where revised procedures and new technologies could improve current practices for prevention of perinatal GBS disease. The key decision issued after the conference is to recommend intrapartum antimicrobial prophylaxis based on a universal intrapartum GBS screening strategy using a rapid real time testing.

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“…However, it should not be forgotten that there have been reports on declining amount of studies towards detection of GBS carriers between 35 and 37 weeks of gestation. It has been shown that at this stage, about 6% pregnant women colonized by GBS had negative results of GBS cultures [17]. In 2010, Berardi et al published a study where they found that the majority of cases of early-onset GBS infection among newborns in years 2003-2008 were related to mothers who had a negative screening result for S. agalactiae.…”

Section: Newborn Infections and Prophylaxismentioning

confidence: 99%

“…Wykazano bowiem, że na tym etapie ciąży około 6% skolonizowanych GBS ciężarnych posiada ujemne wyniki posiewów w kierunku GBS [17]. Również w 2010 roku Berardi i wsp.…”

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The effect of perinatal antibiotic prophylaxis on an early onset of symptomatic infections in newborns

Szymański

Szczerba²,

Konstanty-Kurkiewicz

2017

Pielegniarstwo XXI Wieku / Nursing in the 21st Century

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STRESZCZENIEWPŁYW STOSOWANIA OKOŁOPORODOWEJ PROFILAKTYCZNEJ ANTYBIOTYKOTERAPII NA WYSTĘPOWANIE ZAKAŻEŃ WCZESNO-OBJAWOWYCH U NOWORODKÓW Cel pracy. Celem pracy była ocena skuteczności profilaktycznej okołoporodowej antybiotykoterapii na występowanie wczesnoobjawowych zakażeń. Materiały i metodyka. Materiał do badań stanowiły uzyskane z historii chorób dane 1328 żywo urodzonych, pojedynczych noworodków i ich matek. Badane parametry ciągłe opisano podając liczebność, średnią arytmetyczną, odchylenie standardowe, medianę oraz najmniejszą i największą wartość. Do analizy frakcji użyto testu Chi kwadrat; także z poprawką Yatesa (dla małych liczebności komórek). Poziom istotności statystycznej przyjęto dla p<0,05. Wyniki. U 6,62% noworodków wystąpiło zakażenie wczesno-objawowe. Infekcję GBS stwierdzono u 14 z nich, lecz tylko u 5 z nich wyizolowano wyłącznie GBS. E. coli stwierdzono u 33 noworodków, a "inne bakterie", w tym Enterococcus faecalis, Enterobacteriaceae, Staphylococcus epidermidis, Staphylococcus aureus wyizolowano od 42 noworodków. U 24 noworodków występowały objawy kliniczne zakażenia oraz dodatnie wskaźniki stanu zapalnego w badaniach laboratoryjnych, przy ujemnych wynikach posiewów bakteriologicznych. Wnioski. W związku z wprowadzeniem obowiązku wykonywania badań w kierunku GBS ilość stosowanej antybiotykoterapii wzrasta. Skuteczność śródporodowej antybiotykoterapii oraz jest powszechność wydają się być zadowalające. Kolor wód płodowych może mieć wpływ na występowanie infekcji wewnątrzmacicznej, w tym wczesnoobjawowego zakażenia GBS. Słowa kluczowe: nosicielstwo GBS, zakażenie, poród, antybiotykoterapia ABSTRACT THE EFFECT OF PERINATAL ANTIBIOTIC PROPHYLAXIS ON AN EARLY ONSET OF SYMPTOMATIC INFECTIONS IN NEWBORNSAim. The aim of the study was to evaluate the effectiveness of preventive perinatal antibiotic therapy on the occurrence of an earlysymptomatic infections in newborns. Material and Methods. The studied material consisted of data obtained from medical records of 1,328 born alive infants and their mothers. Advanced parameters were described with appropriate numbers, arithmetic means, standard deviation, median as well as minimum and maximum values. The level of statistical significance was p<0.05. Results.When it comes to 6.62% of newborns, they demonstrated the presence of early signs of infection. The Group B Streptococcus (GBS) infection was found in 14 cases, but only in 5 of them pure GBS strains were isolated. E. coli bacteria was reported in 33 neonates, while the other bacteria naming: Enterococcus faecalis, Enterobacteriaceae, Staphylococcus epidermidis, Staphylococcus aureus were isolated from 42 newborns. Among 24 newborns showing clinical signs of infection and positive indicators of inflammation in laboratory tests, simultaneously negative results of bacteriological cultures were reported. Conclusions. In connection with the introduction of an obligation to perform tests for GBS, amount of used antibiotics is increasing. However, the effectiveness of intrapartum antibiotic therapy and ...

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Timing of Group B Streptococcus Screening in Pregnancy: A Systematic Review

Cited by 62 publications

References 103 publications

Accuracy of prenatal culture in predicting intrapartum group B streptococcus colonization status

Accuracy of prenatal culture in predicting intrapartum group B streptococcus colonization status

Intrapartum GBS screening and antibiotic prophylaxis: a European consensus conference

The effect of perinatal antibiotic prophylaxis on an early onset of symptomatic infections in newborns

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