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Efficacy of a universal screening program for the prevention of neonatal group B streptococcal disease
M de Cueto1, M J Sánchez, L Moltó
1Microbiology Service, Virgen de las Nieves Hospital, Granada, Spain.
Insights
Universal screening for group B streptococcus (GBS) during pregnancy identified carriers. This approach enabled timely intrapartum antibiotic prophylaxis and early detection of GBS colonization in newborns, reducing neonatal disease risk.
Area of Science:
- Obstetrics and Gynecology
- Neonatal Medicine
- Infectious Diseases
Background:
- Group B Streptococcus (GBS) is a leading cause of neonatal sepsis.
- Universal screening for GBS in pregnant women can identify carriers.
- Intrapartum antibiotic prophylaxis is recommended for GBS carriers to prevent neonatal transmission.
Purpose of the Study:
- To evaluate the effectiveness of universal antepartum GBS screening using Granada medium.
- To assess the impact of this protocol on intrapartum ampicillin prophylaxis and neonatal GBS disease.
- To determine the rate of GBS colonization in infants born to screened mothers.
Main Methods:
- Implementation of universal antepartum vaginal cultures for GBS detection.
- Close monitoring and microbiological culturing of infants born to GBS-positive mothers.
- Documentation of intrapartum ampicillin prophylaxis administration and neonatal outcomes.
Main Results:
- GBS was detected in 12% (543/4,525) of pregnant women.
- Of 253 women who did not receive prophylaxis, 120 infants were colonized, with one case of neonatal GBS disease.
- The protocol facilitated prophylaxis for most GBS carriers and early identification of colonized newborns.
Conclusions:
- Universal antepartum GBS screening is effective in identifying carriers.
- The protocol supports targeted intrapartum prophylaxis and reduces neonatal GBS disease.
- Early identification of colonized newborns is a key benefit of this screening approach.
Abstract:
Universal antepartum vaginal cultures for group B streptococcus (GBS) were initiated in a Spanish hospital in 1994 using Granada medium. Infants born to carriers were monitored closely, and blood, urine and mucocutaneous areas were cultured for GBS. Group B streptococcus was detected in 543 of 4,525 women (12%). Of these, 454 gave birth vaginally, of whom 201 (44%) received intrapartum ampicillin. Prophylaxis was not administered to 253 women (56%). In this group, infants of 120 women were colonized and 1 case of neonatal GBS disease occurred. Using this protocol, most GBS carriers with risk factors received intrapartum prophylaxis. This protocol also led to early identification of colonized newborns.