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

V Björklund1, T Nieminen1, V M Ulander2

  • 1a Children's Hospital, University of Helsinki and Helsinki University Hospital , Helsinki , Finland , and.

The Journal of Maternal-Fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians
|April 2, 2016
PubMed

Insights

A rapid group B streptococcus (GBS) PCR test reduced newborn hospital stays in pediatric care without increasing antibiotic use. This point-of-care test aids in detecting GBS colonization and preventing early-onset GBS disease.

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.
Abstract

Keywords:
GBS early onset diseasegroup B streptococcusneonatesobservational studyrapid diagnostic test

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