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Updated: Sep 23, 2026
A Murine Model of Group B Streptococcus Vaginal Colonization
Published on: November 16, 2016
Compliance with the Centers for Disease Control and Prevention antenatal culture protocol for preventing group B
1Department of Obstetrics and Gynecology, Genesee Hospital and University of Rochester School of Medicine and Dentistry, New York, USA.
Insights
Physician and staff education improved compliance with group B streptococcus (GBS) culture protocols. Despite high compliance, some women with GBS risk factors were not treated, though no GBS sepsis cases occurred.
Area of Science:
- Obstetrics and Gynecology
- Infectious Disease Prevention
- Neonatal Health
Background:
- Group B streptococcal (GBS) sepsis is a significant cause of neonatal morbidity and mortality.
- Antenatal screening and intrapartum antibiotic prophylaxis are key strategies for prevention.
- The Centers for Disease Control and Prevention (CDC) established a protocol for antenatal GBS culture.
Purpose of the Study:
- To evaluate compliance with the CDC antenatal culture protocol for GBS sepsis prevention.
- To assess the impact of extensive physician and staff education on protocol adherence.
Main Methods:
- Retrospective chart review of vaginal deliveries over a 6-month period.
- Analysis of protocol compliance for culturing and antibiotic use.
- Evaluation of educational interventions for healthcare providers.
Main Results:
- Overall prevalence of GBS at >= 35 weeks' gestation was 20%.
- Protocol compliance was 80% for timely cultures and 84% for appropriate antibiotic use.
- A significant compliance failure involved neglecting treatment for women with specific antepartum risk factors (21%).
Conclusions:
- While overall compliance is high, specific antepartum risk factors require focused attention for treatment.
- Further education and quality assurance are necessary to minimize protocol failures.
- No cases of GBS sepsis were reported during the study period, suggesting protocol effectiveness.
Objective:
Our purpose was to measure the compliance with the Centers for Disease Control and Prevention antenatal culture protocol for preventing group B streptococcal sepsis after extensive education of physicians and staff.
Study Design:
After 2 months of educational activities to familiarize attending physicians, nurses, and laboratory staff with the guidelines, a retrospective chart review of all vaginal deliveries over a 6-month period were analyzed for protocol compliance and failures either of culturing or antibiotic use.
Results:
Overall, there was a 20% prevalence rate of group B streptococci found at > or = 35 weeks' gestation. The enhanced broth preincubation did not significantly increase this rate. Compliance with the protocol was 80% for appropriately timed cultures and 84% for use of antibiotics; 0.7% received unindicated antibiotics.
Conclusion:
The area of greatest compliance failure was neglecting to treat women with antepartum risk factors that did not require antepartum cultures: previously affected neonates with group B streptococcal sepsis, antepartum group B streptococcal bacteriuria, and preterm labor and delivery. Twenty-one percent (14/66) of women having these antepartum risk factors were not treated. Protocol failure resulting in no cultures being done occurred in 9% of the women studied (87/956). Further education and quality assurance activities can lower these numbers. There were no cases of group B streptococcal sepsis during the 6 months of this study.
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