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Early-onset group B streptococcus prevention protocols in New Zealand public hospitals
Isobelle A Gosling1, Peter R Stone, Keith Grimwood
1Department of Paediatrics and Child Health, Wellington School of Medicine and Health Sciences, New Zealand.
Insights
Group B Streptococcus (GBS) prevention policies in New Zealand hospitals vary. Hospitals with GBS prevention strategies show lower early-onset GBS disease rates, indicating the importance of implementing these protocols.
Area of Science:
- Obstetrics and Gynecology
- Infectious Disease Prevention
- Neonatal Health
Background:
- Group B Streptococcus (GBS) is a significant cause of early-onset neonatal infection.
- Effective prevention strategies are crucial for reducing GBS-related morbidity and mortality.
- Current GBS prevention protocols in New Zealand require evaluation.
Purpose of the Study:
- To determine the current group B Streptococcus (GBS) prevention protocols implemented in New Zealand hospitals.
- To assess the adherence to and effectiveness of existing GBS prevention strategies.
Main Methods:
- A questionnaire survey was conducted across 19 hospitals in New Zealand.
- These hospitals collectively account for 73% of all births in the country.
- Data on GBS screening and prevention policies were collected and analyzed.
Main Results:
- 84% of surveyed hospitals reported having GBS prevention policies, utilizing bacteriological screening, risk-factor determination, or both.
- However, only 42% of centers using risk assessment correctly administered antibiotics for all high-risk criteria.
- Inadequate specimen collection and culture methods limited the effectiveness of culture-based strategies in all hospitals.
- Hospitals with established GBS prevention policies demonstrated significantly lower rates of early-onset GBS disease (0.46 vs. 1.44 per 1,000 births).
Conclusions:
- While a majority of New Zealand hospitals have GBS prevention policies, full implementation of nationally agreed guidelines is suboptimal.
- Improvements in specimen handling and adherence to risk-assessment protocols are needed.
- Implementing comprehensive GBS prevention strategies is associated with reduced early-onset GBS disease, highlighting the importance of standardized guidelines.
Objective:
Determine group B streptococcus (GBS) prevention protocols.
Methods:
Questionnaire survey of 19 hospitals accounting for 73% of New Zealand births.
Results:
Prevention policies were reported by 16 (84%) hospitals (bacteriological-screening n = 4, risk-factor determination n = 8, both strategies n = 4). Only five out of 12 (42%) centres using risk-assessment administered antibiotics for all high-risk criteria. Inadequate specimen collection and culture methods meant no hospital maximised culture-based strategies. Nevertheless, hospitals with prevention policies had lower early-onset GBS disease rates (0.46 versus 1.44 per 1,000 births; OR 0.32; (95% CI 0.12, 0.98)).
Conclusions:
Prevention strategies can be further improved by hospitals fully implementing nationally agreed guidelines.