Intrapartum GBS screening and antibiotic prophylaxis: a European consensus conference

Area of Science:

• Obstetrics and Gynecology
• Neonatal Medicine
• Clinical Microbiology

Background:

• Group B Streptococcus (GBS) is a primary cause of severe neonatal infections globally.
• Current prevention strategies for early-onset neonatal GBS disease vary in effectiveness and implementation across Europe.
• Debate continues regarding optimal methods for identifying candidates for intrapartum antimicrobial prophylaxis and addressing antibiotic administration drawbacks.

Framework:

• A 2013 expert conference convened to establish consensus on European guidelines for preventing perinatal GBS disease.
• The conference reviewed existing data, identified suboptimal practices, and explored improvements through revised procedures and new technologies.
• The primary recommendation is for intrapartum antimicrobial prophylaxis guided by universal intrapartum GBS screening.

Implementation:

• Universal antenatal GBS screening has demonstrated significant reductions (up to 80%) in neonatal GBS disease incidence in countries like the USA.
• Some European nations utilize antenatal screening, risk-based strategies, or combined approaches, while others lack national guidelines.
• Accurate population-based incidence data for GBS neonatal disease are lacking in some regions, hindering effective strategy evaluation.

Implications:

• Implementing universal intrapartum GBS screening with rapid real-time testing is proposed to enhance GBS disease prevention in newborns.
• Standardized European guidelines are needed to address inconsistencies in GBS prevention strategies and improve maternal and neonatal outcomes.
• Improved data collection on GBS incidence is crucial for evaluating the effectiveness of implemented prevention measures.