Prevention of early-onset neonatal group B streptococcal infection: neonatal outcome after introduction of national screening guideline

Česká verzia

Authors: O. Šimetka ¹; M. Pětroš ¹; H. Podešvová ²
Authors place of work: Porodnicko-gynekologická klinika, FN Ostrava, přednosta MUDr. O. Šimetka ¹; Oddělení neonatologie, FN Ostrava, primářka MUDr. R. Kolářová ²
Published in the journal: Ceska Gynekol 2010; 75(1): 41-46

Summary

Objective:
To evaluate the effectiveness of introduction of national guideline to prevent early-onset group B streptococcal (EOGBS) disease, number of screened women and incidence of GBS colonization.

Design:
Retrospective cohort study.

Setting:
Department of Obstetrics and Gynaecology, Department of Neonatology, University Hospital Ostrava.

Subject and method:
We reviewed 8484 consecutive term pregnancies of women who delivered in our hospital, between years 1999-2001 before the introduction of guideline and years 2003-2005 following the guideline.

Results:
In group 1999-2001 there were 12/3581 (3.35 š) neonates with EOGBS infection in which 7/3581 (1.96 š) had invasive disease. In group 2003-2005 there were 14/4903 (2.86 š) neonates with EOGBS infection (p=68,33%), in which 6/4903 (1,22 š) had invasive disease (p=39,52%). Number of screened women in years 2003-2005 increased from 40% to 65%, and 69% respectively. There were 577/3019 (19%) of GBS colonized women.

Conclusion:
There was 15% decrease of EOGBS disease following the introduction of guideline. Number of screened women increased by 29% in three-year period. GBS colonization in pregnant women is 19%.

Key words:
group B streptococcus, GBS prophylaxis, screening, guideline.

Zdroje

1. Centers for Disease Control and Prevention. Prevention of perinatal group B streptococcal disease: a public health perspective. MMWR, 1996, 45, p. 1-24.

2. Centers for Disease Control and Prevention. Prevention of perinatal group B streptococcal disease: Revised guidelines from CDC. MMWR, 2002, 51, p. 1-22.

3. Barcaite, E., Bartusevicius, A., Tameliene, R., et al. Prevalence of maternal group B streptococcal colonisation in European countries. Acta Obstet Gynecol Scand, 2008, 87, p. 260-271.

4. Beardsall, K., Thompson, MH., Mulla, RJ. Neonatal group B streptococcal infection in South Bedfordshire, 1993–1998. Arch Dis Child Fetal Neonatal Ed, 2000, 82, p. F205-F207.

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

6. Brimil, N., Barthell, E., Heindrichs, U., et al. Epidemiology of Streptococcus agalactiae colonization in Germany. Zentralblatt fur Bakteriologie. Int J Med Microbiol, 2006, 296, p. 39-44.

7. Busetti, M., D’Agaro, P., Campello, C. Group B streptococcus prevalence in pregnant women from North-Eastern Italy: advantages of a screening strategy based on direct plating plus broth enrichment. J Clin Pathol, 2007, 60, p. 1140-1143.

8. Eisenberg, VH., Raveh, D., Meislish, Y., et al. Prevention of Early-Onset Neonatal Group B Streptococcal Infection: is universal screening by culture universally applicable?. Isr Med Assoc J, 2006, 8, p. 698-702.

9. Gilbert, R. Prenatal screening for group B streptococcal infection: gaps in the evidence. Int J Epidemiol, 2004, 33, p. 2.

10. Holec, V. Vyšetření GBS aneb screening Streptococcus agalactiae v těhotenství. Zdravotní ústav Ostrava [online]. Poslední revize 29.7.2005 [cit. 2009-02-27]. Dostupné z < http://www.zuova.cz/informace/mgt002.php>.

11. Cheon-Lee, E., Amstey, MS. Compliance with the Centers for Disease Control and Prevention antenatal culture protocol for preventing group B streptococcal neonatal sepsis. Am J Obstet Gynecol, 1998, 179, p. 77-79.

12. Kowalska, B., Niemiec, KT., Drejewicz, H., et al. Prevalence of group B streptococcal colonization in pregnant women and their newborns based on the results of examination of patients in the Obstetric and Gynecology Department of the National Research Institute of Mother and Child—a pilot study. Ginekol Pol, 2003, 74, p. 1223-1227.

13. Macko, J., Zach, J. Postup péče o novorozence Streptococcus agalactiae (GBS) negativních, pozitivních nebo nevyšetřených matek. Čes Gynek, 2008, 73, S1, s. 39-42.

14. Matorras, R., Pijoan, JI., García-Perea, A. Group B streptococcal prophylaxis randomized trials. Am J Obstet Gynecol, 1995, 172, p. 1326-1327.

15. Melin, P., Schmitz, M., Tsobo, C., et al. Rapid intrapartum test (Strep B OIA) and prenatal cultures for identification of group B streptococcal carriers at delivery: a prospective study. In 40 th Intersciences Conference on Antimicrobial Agents and Chemotherapy (ICAAC), 2000, Toronto, Canada, Abstract book, p. 145, no. 357.

16. Měchurová, A. Infekce streptokoky skupiny B, screening, léčba v těhotenství - doporučené postupy. Prakt Lek, 2006, 86, s. 92-94.

17. Měchurová, A., Unzeitig, V., Vlk, R. Doporučený postup při diagnostice a léčbě streptokoků skupiny B v těhotenství a za porodu. Prakt Gynek, 2005, 9, s. 15-16.

18. Měchurová, A., Unzeitig, V., Vlk, R.. Doporučený postup při diagnostice a léčbě kolonizace streptokoky skupiny B v těhotenství a za porodu. Klin Mikrobiol Inf Lek, 2006, 12, s. 76-77.

19. Měchurová, A., Unzeitig, V., Vlk, R. Doporučený postup při diagnostice a léčbě streptokoků skupiny B v těhotenství a za porodu. Moderní Gynek Porod, 2007, 16, supp.A, s. 129-131.

20. Měchurová, A., Vlk, R., Unzeitig, V. Doporučený postup při screeningu a léčbě streptokoků skupiny B v těhotenství. Čes Gynek, 2004, 69, s. 421-422.

21. Měchurová, A., Vlk, R., Unzeitig, V. Doporučený postup při screeningu a léčbě streptokoků skupiny B v těhotenství a za porodu. Čes Gynek, 2008, 73, S1, s. 7-8.

22. Moore, MR., Schrag, SJ., Schuchat, A. Effects of intrapartum antimicrobial prophylaxis for prevention of group-B-streptococcal disease on the incidence and ecology of early-onset neonatal sepsis. Lancet Infect Dis, 2003, 3, p. 201-213.

23. Morales, WJ., Lim, DV., Walsh, AF. Prevention of neonatal group B streptococcal sepsis by the use of a rapid screening test and selective intrapartum chemoprophylaxis. Am J Obstet Gynecol, 1986, 155, p. 979-983.

24. Oddie, S., Embleton, ND. Risk factors for early onset neonatal group B streptococcal sepsis: case-control study. BMJ, 2002, 325, p. 308.

25. Puopolo, KM., Madoff, LC., Eichenwald, EC. Early-onset group B streptococcal disease in the era of maternal screening. Pediatrics, 2005, 115, p. 1240-1246.

26. Quinlan, JD., Hill, DA., Maxwell, BD., et al. The necessity of both anorectal and vaginal cultures for group B streptococcus screening during pregnancy. J Fam Pract, 2000, 49, p. 447-448.

27. Regan, JA., Klebanoff, MA., Nugent, RP. Vaginal Infections and Prematurity Study Group. The epidemiology of group B streptococcal colonization in pregnancy. Obstet Gynecol, 1991, 77, p. 604–610.

28. Reingold, A., Gershman, K., Petit, S., et al. Perinatal Group B Streptococcal Disease After Universal Screening Recommendations. MMWR, 2007, 56, p. 701-705.

29. Riley, L., Appollon, K., Haider, S.,et al. “Real World” Compliance With Strategies to Prevent Early-Onset Group B Streptococcal Disease. J Perinatol, 2003, 23, p. 272-277.

30. Santos, C., Mendinhos, G., Sancho, L., et al. Screening Group B Streptococcus colonization in 98.6% of pregnant women - is it enough? J Maternal - Fetal & Neonatal Med: Book of Abstracts, 2006, 19, p. 15-16.

31. Schrag, SJ., Zell, ER., Lynfield, R., et al. A population-based comparison of strategies to prevent early-onset group B streptococcal disease in neonates. N Engl J Med, 2002, 347, p. 233-239.

32. Schrag, SJ., Zywicki, S., Farley, MM., et al. Group B streptoccocal disease in the era of intrapartum antibiotic prophylaxis. N Engl J Med, 2000, 342, p. 15–20.

33. Schuchat, A. Neonatal group B streptococcal disease – screening and prevention. N Engl J Med, 2000, 343, p. 209-210.

34. Spellerberg, B. Pathogenesis of neonatal Streptococcus agalactiae infections. Microbes and Infection, 2000, 2, p. 1733-1742.

35. Straková, L., Motlová, J. Jsou u nás evidovaná novorozenecká onemocnění časného typu vyvolaná Streptococcus agalactiae špičkou ledovce? První výsledky aktivní surveillance leden–prosinec 2001. Zprávy CEM (SZÚ, Praha), 2001, 11, s. 25-27.

36. Straková, L., Motlová, J. Active surveillance or early neonate infections caused by Streptococcus agalactiae. Indian J Med Res, 2004, 119, supp., p. 205-207.

37. Trijbels-Smeulders, MA., Kollée, LA., Adriaanse, AH., et al. Neonatal group B streptococcal infection: incidence and strategies for prevention in Europe. Pediatr Infect Dis J, 2004, 23, p. 172-173.

38. Tuppurainen, N., Hallman, M. Prevention of neonatal group B streptococcal disease: intrapartum detection and chemoprophylaxis of heavily colonized parturients. Obstet Gynecol, 1989, 73, p. 583-587.

39. Vlk, R., Měchurová, A. Streptokoky skupiny B v těhotenství a za porodu – doporučený postup. Neonatol listy, 2004, 10, s. 20-21.

40. Zaleznik, DF., Rench, MA., Hillier, S., et al. Invasive disease due to group B streptococcus in pregnant women and neonates from diverse population groups. Clin Infect Dis, 1999, 30, p. 276-281.