Evaluation of a Surveillance Program for the Prevention of Perinatal Group B Streptococcal Disease in Neonates

BACKGROUND: The American College of Obstetricians and Gynecologists, the American College of Nurse-Midwives, and the Centers for Disease Control recommends prophylaxis to prevent perinatal Group B Streptococcal (GBS) disease. GBS is the leading cause of morbidity and mortality among neonates. Universal screening for GBS through vaginal and rectal culturing was done on 868 pregnant women for Group B streptococcus (GBS). METHODS: The SofLab database was used to identify the pregnant women screened for GBS during a 6-month period. Records of 151(17%) women screened with evidence of GBS carriage were reviewed to determine if specimens were collected at 35–37 weeks gestation, prophylaxis was initiated, and appropriate antibiotics used. RESULTS: Two carriers were screened at <35 weeks gestation and 23 (15%) were screened at >37 weeks gestation. Of the 151 carriers, 113 (75%) had initiation of appropriate antibiotics at the time of delivery. There were only five (3%) instances where antibiotic therapy was not initiated. Due to precipitous delivery, five (3%) patients were also not given antibiotic therapy. A total of 25 (17%) of patients were lost in follow up or delivered outside of our health system. There were three (2%) women who declined antibiotics or for whom treatment was not indicated. CONCLUSIONS: The majority of screened women agree to be treated prophylactically to prevent perinatal GBS disease.