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Continued early onset group B streptococcal infections in the era of intrapartum prophylaxis

Journal of Perinatology volume 29, pages 20–25 (2009)Cite this article

Abstract

Objective

The objective of the study was to determine the rate of early onset group B streptococcus (EOGBS) infection in Utah and identify potential areas of failure in EOGBS prevention.

Study Design

We queried the microbiology records of Intermountain Healthcare for infants with culture-confirmed EOGBS between 1 January 2002 and 31 May 2006 and calculated rates of EOGBS per 1000 deliveries. We reviewed the infant and maternal records of each EOGBS case to identify possible failures in EOGBS prevention.

Result

There were 54 cases of EOGBS among the 127 205 births (0.42/1000 births). Of all, 12 were preterm. Of the 39 (93%) women prenatally screened for GBS, 31 (79%) had negative results and 7/8 (88%) women with positive prenatal GBS screens either did not receive intrapartum antibiotic prophylaxis (IAP) or received inadequate IAP. Of the 54 infants with EOGBS, 3 (6%) died.

Conclusion

Utah's rates of EOGBS were higher than the national average. Factors associated with EOGBS include missed screening opportunities, inadequate IAP, and false-negative maternal GBS culture.

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References

  1. Baker CJ, Barrett FF, Gordon RC, Yow MD . Suppurative meningitis due to streptococci of Lancefield group B: a study of 33 infants. J Pediatr 1973; 82 (4): 724–729.

    Article  CAS  PubMed  Google Scholar 

  2. Barton LL, Feigin RD, Lins R . Group B beta hemolytic streptococcal meningitis in infants. J Pediatr 1973; 82 (4): 719–723.

    Article  CAS  PubMed  Google Scholar 

  3. Franciosi RA, Knostman JD, Zimmerman RA . Group B streptococcal neonatal and infant infections. J Pediatr 1973; 82 (4): 707–718.

    Article  CAS  PubMed  Google Scholar 

  4. McCracken Jr GH . Group B streptococci: the new challenge in neonatal infections. J Pediatr 1973; 82 (4): 703–706.

    Article  PubMed  Google Scholar 

  5. Boyer KM, Gotoff SP . Prevention of early-onset neonatal group B streptococcal disease with selective intrapartum chemoprophylaxis. N Engl J Med 1986; 314 (26): 1665–1669.

    Article  CAS  PubMed  Google Scholar 

  6. Schrag S, Gorwitz R, Fultz-Butts K, Schuchat A . Prevention of perinatal group B streptococcal disease. Revised guidelines from CDC. MMWR Recomm Rep 2002; 51 (RR-11): 1–22.

    PubMed  Google Scholar 

  7. Centers for Disease Control and Prevention. Prevention of perinatal group B streptococcal disease: a public health perspective. MMWR Recomm Rep 1996; 45 (RR-7): 1–24.

  8. Schuchat A, Hilger T, Zell E, Farley MM, Reingold A, Harrison L et al. Active Bacterial Core surveillance of the emerging infections program network. Emerg Infect Dis 2001; 7 (1): 92–99.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Zangwill KM, Schuchat A, Wenger JD . Group B streptococcal disease in the United States, 1990: report from a multistate active surveillance system. MMWR CDC Surveill Summ 1992; 41 (6): 25–32.

    CAS  PubMed  Google Scholar 

  10. Active Bacterial Core Surveillance (ABCs) Report, Emerging Infections Program Network: group B streptococcus, 2004. Centers for Disease Control and Prevention Web Site. http://www.cdc.gov/ncidod/dbmd/abcs/survreports.htm. Accessed February 20, 2008.

  11. Centers for Disease Control and Prevention (CDC). Diminishing racial disparities in early-onset neonatal group B streptococcal disease—United States, 2002–2003. MMWR 2004; 53 (23): 502–505.

    Google Scholar 

  12. Centers for Disease Control and Prevention (CDC). Perinatal group B streptococcal disease after universal screening recommendations—United States, 2003–2005. MMWR 2007; 56 (28): 701–705.

    Google Scholar 

  13. Active Bacterial Core Surveillance (ABCs) Report, Emerging Infections Program Network: group B streptococcus, 2005. Centers for Disease Control and Prevention Web Site. http://www.cdc.gov/ncidod/dbmd/abcs/survreports.htm. Accessed February 20, 2008.

  14. Utah's vital statistics: births and deaths, 2005—complete report. (Accessed at http://health.utah.gov/vitalrecords/Stats/2005data.htm.).

  15. Glasgow TS, Young PC, Wallin J, Kwok C, Stoddard G, Firth S et al. Association of intrapartum antibiotic exposure and late-onset serious bacterial infections in infants. Pediatrics 2005; 116 (3): 696–702.

    Article  PubMed  Google Scholar 

  16. Rowen J, Baker CJ . Group B streptococcal infections. In: Feigin R, Cherry JD, Demmler GJ, Kaplan SL (eds). Textbook of Pediatric Infectious Diseases, 5th edn. Saunders: Philadelphia, Penn, 2004, pp 1159–1163.

    Google Scholar 

  17. Baker CJ . Early onset group B streptococcal disease. J Pediatr 1978; 93 (1): 124–125.

    Article  CAS  PubMed  Google Scholar 

  18. Schrag SJ, Zywicki S, Farley MM, Reingold AL, Harrison LH, Lefkowitz LB et al. Group B streptococcal disease in the era of intrapartum antibiotic prophylaxis. N Engl J Med 2000; 342 (1): 15–20.

    Article  CAS  PubMed  Google Scholar 

  19. Schuchat A . Group B streptococcal disease in newborns: a global perspective on prevention. Biomed Pharmacother 1995; 49 (1): 19–25.

    Article  CAS  PubMed  Google Scholar 

  20. Puopolo KM, Madoff LC, Eichenwald EC . Early-onset group B streptococcal disease in the era of maternal screening. Pediatrics 2005; 115 (5): 1240–1246.

    Article  PubMed  Google Scholar 

  21. Ostroff RM, Steaffens JW . Effect of specimen storage, antibiotics, and feminine hygiene products on the detection of group B streptococcus by culture and the STREP B OIA test. Diagn Microbiol Infect Dis 1995; 22 (3): 253–259.

    Article  CAS  PubMed  Google Scholar 

  22. Dillon Jr HC, Gray E, Pass MA, Gray BM . Anorectal and vaginal carriage of group B streptococci during pregnancy. J Infect Dis 1982; 145 (6): 794–799.

    Article  PubMed  Google Scholar 

  23. Yancey MK, Schuchat A, Brown LK, Ventura VL, Markenson GR . The accuracy of late antenatal screening cultures in predicting genital group B streptococcal colonization at delivery. Obstet Gynecol 1996; 88 (5): 811–815.

    Article  CAS  PubMed  Google Scholar 

  24. Bergeron MG, Ke D, Menard C, Picard FJ, Gagnon M, Bernier M et al. Rapid detection of group B streptococci in pregnant women at delivery. N Engl J Med 2000; 343 (3): 175–179.

    Article  CAS  PubMed  Google Scholar 

  25. Rallu F, Barriga P, Scrivo C, Martel-Laferriere V, Laferriere C . Sensitivities of antigen detection and PCR assays greatly increased compared to that of the standard culture method for screening for group B streptococcus carriage in pregnant women. J Clin Microbiol 2006; 44 (3): 725–728.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  26. Picard FJ, Bergeron MG . Laboratory detection of group B streptococcus for prevention of perinatal disease. Eur J Clin Microbiol Infect Dis 2004; 23 (9): 665–671.

    Article  CAS  PubMed  Google Scholar 

  27. Haberland CA, Benitz WE, Sanders GD, Pietzsch JB, Yamada S, Nguyen L et al. Perinatal screening for group B streptococci: cost–benefit analysis of rapid polymerase chain reaction. Pediatrics 2002; 110 (3): 471–480.

    Article  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Pediatrics, University of Utah, Salt Lake City, UT, USA

    L S Pulver, M M Hopfenbeck, P C Young & C L Byington

  2. Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA

    G J Stoddard

  3. Microbiology Laboratory, Primary Children's Medical Center, Salt Lake City, UT, USA

    K Korgenski & J Daly

Authors
  1. L S Pulver
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  2. M M Hopfenbeck
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  3. P C Young
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  4. G J Stoddard
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  5. K Korgenski
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  6. J Daly
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  7. C L Byington
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Correspondence to L S Pulver.

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Pulver, L., Hopfenbeck, M., Young, P. et al. Continued early onset group B streptococcal infections in the era of intrapartum prophylaxis. J Perinatol 29, 20–25 (2009). https://doi.org/10.1038/jp.2008.115

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