Abstract 1026 Poster Session II, Sunday, 5/2 (poster 98)

The rate of neonatal GBS disease has declined nationally since 1996 when the CDC issued guidelines for prevention, based on either a GBS screening or risk-based strategy. An association between institution of hospital policy for prevention of GBS disease by either strategy and decrease in incidence of early-onset GBS disease has been shown (MMWR 37:665, 1998) but association between actual hospital practices and decrease in disease has not be demonstrated. We reviewed computerized hospital records to determine whether there is an association between implementation of a combined GBS screening/risk-based prevention strategy and the observed decline in GBS in term newborns from 1993 through 1997 (rates per 1000 births for consecutive years: 4.5, 5.9, 2.7, 0.7, and 0.0) at MHMC. The analysis is based on 3 components of the prevention strategy: 1) percent of women screened for GBS, 2) percent of women culture-positive for GBS and 3) use of intrapartum antibiotic prophylaxis (IAP). GBS screening was performed on vaginal-rectal swabs at 36 weeks with selective media. Results are summarized: (Table)

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Summary: The number of cases of neonatal GBS disease decreased prior to implementation of the combined screening/risk factor strategy. Following implementation of the prevention strategy in 1996, the percent of women who received IAP increased from 20 to 32%, accompanied by a further reduction in GBS disease. Conclusion: Use of IAP for GBS-colonized women and women with risk factors for early-onset sepsis is associated with a decrease in GBS disease in term neonates.