Evaluation of a strategy to prevent early neonatal group B streptococcus infection: A prospective cohort study

Abstract

BACKGROUND: Group B streptococcus (GBS) is one of the principal agents of neonatal early onset sepsis (EOS). OBJECTIVE: To evaluate the incidence of GBS colonization and neonatal EOS due to GBS and to describe the compliance of an institutional protocol. METHODS: From January 2007 to December 2010 we conducted a retrospective cohort study to evaluate the incidence of maternal GBS colonization in high risk pregnant women. A protocol was implemented to determine anal/vaginal GBS colonization of all women at 22 to 37 weeks of pregnancy and all patients that presented the following risk factors. Intrapartum antibiotic prophylaxis (IAP) was administered according to the Centers for Disease Control and Prevention (CDC) guidelines. From January 2009 to December 2010, data from the medical records of all newborns at the NICU were also collected to identify the incidence of newborns whose mothers were screened as indicated by the protocol. RESULTS: A total of 4,797 high risk pregnant women were included. The incidence of maternal GBS colonization was 23%. The incidence of neonatal EOS due to GBS was 0.09/1000 live births and a 50% mortality rate. Information regarding GBS maternal colonization was available for 91% of the neonates admitted to the NICU. CONCLUSIONS: The maternal GBS colonization rate was similar to that described in the literature. Information regarding maternal GBS colonization was available to the majority of neonates, which is essential for management of this high risk population. The strategy of surveillance of high risk pregnant women can provide a useful and feasible strategy.