Updates in prevention policies of early-onset group B streptococcal infection in newborns

Abstract

Invasive disease owing to group B Streptococcus (GBS) is a major cause of illness and death among newborns. Maternal GBS colonization of gastrointestinal tract and/or vagina is the primary risk factor for neonatal GBS early-onset disease (EOD). In Europe and America, there are marked declines in neonatal GBS-EOD through widespread implementation of guidelines for maternal GBS screening and subsequent intrapartum antibiotic prophylaxis (IAP). The key measures necessary for prevention of GBS-EOD include correct specimen collection and processing, nucleic acid amplification testing (NAAT) for GBS identification, regimens for mothers with premature rupture of membranes (PROM), preterm labor or penicillin allergy, and coordination between obstetrics and pediatrics. Antibiotic prophylaxis has some disadvantages, so researchers should develop other preventive measures. Maternal vaccines to prevent perinatal GBS infection are currently under development. However, as large, population-based sampling studies are rarely conducted, the colonization rate and the disease burden of GBS in perinatal period are poorly understood in developing countries. The harm of GBS to newborns has been recognized in recent years in mainland China, but authorized prevention measures are still lacking. In order to enhance the understanding of GBS-EOD prevention, the most recent guidelines updates by the American College of Obstetricians and Gynecologists (ACOG) and American Academy of Pediatrics (AAP) in 2019e2020 are summarized in this article.

Bacterial and Host Determinants of Group B Streptococcal Infection of the Neonate and Infant

“…Antibiotics commonly prescribed for IAP remain penicillin and ampicillin ( Le Doare et al, 2017b ), which had little to no observable resistance in these studies. Some guidelines also call for cephalosporins, vancomycin, clindamycin, or azithromycin for IAP in women with low or high risk of penicillin allergy ( Le Doare et al, 2017b ; Zhu and Lin, 2021 ). Resistance to cephalosporins (ceftriaxone and cefuroxime) and vancomycin were observed in a small study of Palestinian newborns and infants ( Awwad et al, 2021 ), while clindamycin resistance appears to be relatively common with consistently high rates in different geographical regions ( Martins et al, 2017 ; Guan et al, 2018 ; Guo et al, 2018 ; Kao et al, 2019 ; Li et al, 2019 ; Nanduri et al, 2019 ; Wu et al, 2019 ; Awwad et al, 2021 ; Kekic et al, 2021 ; Lohrmann et al, 2021 ).…”

Prevalência Da Colonização Por Estreptococo Do Grupo B Em Gestantes Atendidas Em Um Hospital Público

“…As amostras passaram ainda pelo teste da catalase para confirmar a identidade do isolado, ou para verificar se a cultura estava pura. O EGB apresenta o teste da catalase negativo (7) , equivale a 1-2x10 8 UFC/mL (8) .…”

Allium sativum and Group B Streptococcus: antimicrobial and synergistic activity

“…According to the Consensus Reviews, the guidelines were revised in 2002 and 2010, and universal recommendations were issued for the collection of vaginal secretions from all pregnant women between 35 to 37 weeks of gestation (Centers for Disease Control and Prevention 2010). In 2018, the responsibility and management for updating the guidelines were transferred from the CDC to ACOG and AAP (Zhu and Lin 2021).…”