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Published on: August 25, 2014
Management of Infants at Risk for Group B Streptococcal Disease
Insights
Universal antenatal screening for Group B Streptococcus (GBS) is recommended to prevent early-onset neonatal sepsis. Current strategies effectively prevent early-onset GBS disease but not late-onset disease.
Area of Science:
- Neonatal Medicine
- Infectious Diseases
- Obstetrics
Background:
- Group B streptococcal (GBS) infection is a leading cause of neonatal sepsis.
- Intrapartum antibiotic prophylaxis is effective for preventing early-onset GBS disease.
- No current strategy effectively prevents late-onset GBS disease.
Purpose of the Study:
- To provide neonatal clinicians with updated information on GBS disease epidemiology.
- To outline current recommendations for evaluating infants at risk for GBS disease.
- To detail treatment guidelines for confirmed GBS infections.
Main Methods:
- Reaffirmation of universal antenatal microbiologic-based testing for maternal GBS colonization.
- Administration of intrapartum antibiotic prophylaxis based on screening results.
- Clinical evaluation and treatment of newborn infants with suspected or confirmed GBS disease.
Main Results:
- Universal antenatal screening facilitates targeted intrapartum antibiotic prophylaxis.
- Effective prevention of perinatal GBS early-onset disease is achievable.
- Late-onset GBS disease prevention remains a challenge.
Conclusions:
- The American Academy of Pediatrics and ACOG endorse universal antenatal GBS screening.
- Updated clinical guidance is provided for neonatal clinicians.
- This report serves as ACOG clinical guidance for GBS management.
Abstract:
Group B streptococcal (GBS) infection remains the most common cause of neonatal early-onset sepsis and a significant cause of late-onset sepsis among young infants. Administration of intrapartum antibiotic prophylaxis is the only currently available effective strategy for the prevention of perinatal GBS early-onset disease, and there is no effective approach for the prevention of late-onset disease. The American Academy of Pediatrics joins with the American College of Obstetricians and Gynecologists to reaffirm the use of universal antenatal microbiologic-based testing for the detection of maternal GBS colonization to facilitate appropriate administration of intrapartum antibiotic prophylaxis. The purpose of this clinical report is to provide neonatal clinicians with updated information regarding the epidemiology of GBS disease as well current recommendations for the evaluation of newborn infants at risk for GBS disease and for treatment of those with confirmed GBS infection. This clinical report is endorsed by the American College of Obstetricians and Gynecologists (ACOG), July 2019, and should be construed as ACOG clinical guidance.
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