Replacing risk-based early-onset-disease prevention with intrapartum group B streptococcus PCR testing.

Area of Science:

• Medical Microbiology
• Neonatal Care
• Diagnostic Testing

Background:

• Group B Streptococcus (GBS) poses a significant risk for neonatal infections.
• Accurate and timely GBS detection is crucial for preventing early-onset disease (EOD).
• Current diagnostic methods may have limitations in speed and accuracy.

Purpose of the Study:

• To assess the impact of a rapid PCR-based GBS test on neonatal hospital length of stay.
• To evaluate the effect of the rapid GBS test on antibiotic utilization.
• To determine the incidence of GBS-early-onset-disease (EOD) following the implementation of the rapid test.

Main Methods:

• A before-and-after service evaluation was conducted.
• The study included term deliveries over a defined period.
• Data collected included length of hospital stay, GBS-EOD incidence, and antibiotic use.

Main Results:

• The rapid GBS test was associated with a 1.16-day decrease in pediatric care unit length of stay (p=0.01).
• An increase of 1.11 days in mother-and-baby ward length of stay was observed (p<0.001).
• No significant increase in antibiotic use was noted post-implementation.

Conclusions:

• Point-of-care GBS testing reduced pediatric length of stay without increasing antibiotic use.
• The rapid test may enhance GBS colonization detection accuracy.
• Implementation of the intrapartum PCR algorithm was linked to zero verified GBS-EOD cases, suggesting prevention of intrapartum transmission.