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While waiting for a vaccine: opportunities for optimization of neonatal group B streptococcal (GBS) disease

Dan Waisman1, Ayala Gover2, Michal Molad2

  • 1Department of Neonatology, Carmel Medical Center and Faculty of Medicine, Technion - Israel Institute of Technology, 7 Michal St, Haifa, Israel. dwaisman@technion.ac.il.

Journal of Perinatology : Official Journal of the California Perinatal Association
|December 13, 2018
PubMed

Insights

Strategies like intrapartum antibiotic prophylaxis (IAP) and rapid testing can significantly reduce early-onset Group B Streptococcus (GBS) sepsis in newborns. Combining these approaches offers the most effective prevention method.

Area of Science:

  • Neonatal Health
  • Infectious Disease Epidemiology
  • Public Health Interventions

Background:

  • Group B Streptococcus (GBS) remains a significant cause of neonatal early-onset sepsis (EOGBS).
  • Effective strategies are crucial for reducing EOGBS incidence and improving neonatal outcomes.

Purpose of the Study:

  • To quantify the impact of various strategies for decreasing EOGBS in Israel.
  • To evaluate the effectiveness of antepartum and intrapartum interventions.

Main Methods:

  • Adaptation of a risk allocation model for EOGBS to Israeli data.
  • Calculation of effects for antepartum screening (APS), intrapartum screening (IPS), intrapartum antibiotic prophylaxis (IAP), and postpartum antibiotic prophylaxis (PAP).

Main Results:

  • Antenatal screening (APS) and intrapartum antibiotic prophylaxis (IAP) could reduce EOGBS to 0.18/1000.
  • Rapid intrapartum testing may further decrease EOGBS to 0.16/1000, reducing IAP use.
  • Postpartum antibiotic prophylaxis (PAP) can further reduce risk for infants not receiving IAP.

Conclusions:

  • Intrapartum antibiotic prophylaxis (IAP) is the primary intervention for decreasing EOGBS.
  • Combined IAP and PAP may reduce current EOGBS incidence by 40%.
  • A strategy integrating rapid intrapartum screening with selective IAP and PAP is most efficient.
Abstract

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