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While waiting for a vaccine: opportunities for optimization of neonatal group B streptococcal (GBS) disease prevention in Israel

Journal of Perinatology volume 39, pages 331–338 (2019)Cite this article

Subjects

Abstract

Objective:

To quantify effects of different strategies for decreasing neonatal early onset GBS sepsis (EOGBS) in Israel.

Study design:

A risk allocation model for EOGBS among infants ≥ 35w was adapted to Israeli data. Effects of strategies for antepartum (APS) and intrapartum (IPS) screening, and intrapartum (IAP) and/or postpartum antibiotic prophylaxis (PAP) were calculated.

Results:

Estimated EOGBS attack rates (AR) with APS in 90%, IAP in 90%, may reduce AR to 0.18/1000. A rapid intrapartum test would further decrease AR to 0.16/1000, while reducing IAP from 21.3 to 12.5% of women. For babies with risk factors and GBS+ who do not receive IAP, further risk reduction could be achieved by PAP.

Conclusion:

IAP remains the main intervention to decrease EOGBS. IAP and PAP together may reduce EOGBS present incidence by 40%. Combining rapid intrapartum screening with selective IAP and selective PAP for remaining gaps, would be the most efficient strategy.

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Author contributions

Dan Waisman has conceptualized the manuscript, contributed to the development of the adapted algorithm, carried out a literature review, reviewed the manuscript, and approved the final manuscript as submitted. Ayala Gover carried out a literature review, wrote the first draft of the manuscript and approved the final manuscript as submitted. Michal Molad extracted local data at Carmel Medical Center, reviewed and approved the final manuscript as submitted. Reuven Kedar extracted local data at Carmel Medical Center, reviewed and approved the final manuscript as submitted. Avi Rotschild reviewed the concept and approved the final manuscript as submitted. William Benitz reviewed the first draft of the manuscript, developed the algorithm and statistical analysis, reviewed and approved the final manuscript as submitted.

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Authors and Affiliations

  1. Department of Neonatology, Carmel Medical Center and Faculty of Medicine, Technion – Israel Institute of Technology, 7 Michal St, Haifa, Israel

    Dan Waisman, Ayala Gover, Michal Molad & Avi Rotschild

  2. Department of Obstetrics and Gynecology, Carmel Medical Center, and Faculty of Medicine, Technion – Israel Institute of Technology, Michal St, Haifa, Israel

    Reuven Kedar

  3. Stanford University School of Medicine, Division of Neonatal & Developmental Medicine, Palo Alto, CA, 94304, USA

    William E. Benitz

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  1. Dan Waisman
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Correspondence to Dan Waisman.

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The authors declare that they have no conflict of interest.

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Waisman, D., Gover, A., Molad, M. et al. While waiting for a vaccine: opportunities for optimization of neonatal group B streptococcal (GBS) disease prevention in Israel. J Perinatol 39, 331–338 (2019). https://doi.org/10.1038/s41372-018-0289-2

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