Cost‐effectiveness of rapid tests and other existing strategies for screening and management of early‐onset group B streptococcus during labour

Kaambwa, Billingsley; Bryan, Stirling; Gray, J.; Milner, P.; Daniels, Jane; Khan, Khalid S.; Roberts, Tracy

doi:10.1111/j.1471-0528.2010.02752.x

Cited by 31 publications

(19 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…33 Kaambwa et al tried to determine the cost-effectiveness of alternative screening and prevention strategies, including rapid intrapartum testing, for the prevention of early-onset neonatal GBS infection in the UK. 34 The authors found that the most cost-effective strategy was the provision of routine intrapartum antibiotic prophylaxis to all women without prior screening, but they also agreed that this was unlikely to be acceptable, given the broader concerns related to antibiotic use. 34 A 2009 Cochrane review critiqued the effectiveness of intrapartum antibiotic prophylaxis to reduce early-onset neonatal GBS infection.…”

Section: Discussionmentioning

confidence: 97%

Prevalence of maternal group B streptococcus colonization and vertical transmission in low-risk women in a single institute

Yang

Sun

Wen³

et al. 2012

Journal of the Chinese Medical Association

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 97%

Prevalence of maternal group B streptococcus colonization and vertical transmission in low-risk women in a single institute

Yang

Sun

Wen³

et al. 2012

Journal of the Chinese Medical Association

View full text Add to dashboard Cite

show abstract

“…However, because of the reimbursement system used in most countries (diagnostic related groups), hospitals are not inclined to add laboratory examinations to in-hospital treatments, and it is difficult to convince hospital administrators to invest in strategies to spare antibiotic use if their application is more costly than the price of the antibiotic itself. Indeed, as shown by Kaambwa [37], the most costeffective method for the prevention of GBS neonatal sepsis is ''treat all'' (routine untargeted IAP to all). However, this attitude leads to unneeded antibiotic treatment for many pregnant mothers, with associated side effects for the mother and child.…”

Section: Point Of Care Detection Nucleic-acid Based Assays For Screenmentioning

confidence: 99%

“…However, this attitude leads to unneeded antibiotic treatment for many pregnant mothers, with associated side effects for the mother and child. For the moment, the second best approach in terms of cost effectiveness is to base IAP on antenatal cultures [37]. This is, however, likely to change in the next few years.…”

Section: Point Of Care Detection Nucleic-acid Based Assays For Screenmentioning

confidence: 99%

Molecular-based Screening for Perinatal Group B Streptococcal Infection: Implications for Prevention and Therapy

2013

View full text Add to dashboard Cite

Group B streptococci (GBS) are a leading cause of infectious neonatal morbidity and mortality. Timely and accurate identification of colonized pregnant women is imperative to implement intrapartum antibioprophylaxis (IAP) to reduce the risk of early neonatal sepsis. Current guidelines recommend screening for GBS carriage with vaginal-rectal cultures. However, cultures require 24-72 h, thus precluding their use for intrapartum screening and these are only performed at 35-37 weeks gestation. New rapid molecular-based tests can detect GBS within hours. They have the potential to be used intrapartum and to allow for selective IAP in women carrying GBS. An advantage is that they can sometimes be performed by non-laboratory staff in the labor suite, thus avoiding delays in sample transfers to the microbiology laboratory. Another possible use of molecular-based assays is for the diagnosis of neonatal sepsis, where tests with a short turnaround time and high sensitivity and specificity are crucial. In this situation, the detection of microorganisms once antibiotic therapy has already been started is important, as treatment is started immediately once sepsis is suspected without waiting for microbiological confirmation. In this article, we discuss the state-of-the-art molecular-based tests available for GBS screening during pregnancy, as well as their implications for IAP for the diagnosis and prevention of neonatal sepsis.

show abstract

“…Further studies using real-time PCR performed in intrapartum setting were needed to identify targeted population and settings where the test will be most useful. In these last years, studies not supporting the intrapartum PCR screening as a cost-effective strategy in comparison with culture screening at around 35-37 weeks of gestation, used data from older less accurate PCR equipment [32,113].…”

Section: Non-culture Methods For Intrapartum Specimen Processingmentioning

confidence: 99%

Intrapartum GBS screening and antibiotic prophylaxis: a European consensus conference

Renzo

Melin²,

Berardi

et al. 2014

The Journal of Maternal-Fetal & Neonatal Medicine

153

135

View full text Add to dashboard Cite

Group B streptococcus (GBS) remains worldwide a leading cause of severe neonatal disease. Since the end of the 1990s, various strategies for prevention of the early onset neonatal disease have been implemented and have evolved. When a universal antenatal GBS screening-based strategy is used to identify women who are given an intrapartum antimicrobial prophylaxis, a substantial reduction of incidence up to 80% has been reported in the USA as in other countries including European countries. However recommendations are still a matter of debate due to challenges and controversies on how best to identify candidates for prophylaxis and to drawbacks of intrapartum administration of antibiotics. In Europe, some countries recommend either antenatal GBS screening or risk-based strategies, or any combination, and others do not have national or any other kind of guidelines for prevention of GBS perinatal disease. Furthermore, accurate population-based data of incidence of GBS neonatal disease are not available in some countries and hamper good effectiveness evaluation of prevention strategies. To facilitate a consensus towards European guidelines for the management of pregnant women in labor and during pregnancy for the prevention of GBS perinatal disease, a conference was organized in 2013 with a group of experts in neonatology, gynecologyobstetrics and clinical microbiology coming from European representative countries. The group reviewed available data, identified areas where results were suboptimal, where revised procedures and new technologies could improve current practices for prevention of perinatal GBS disease. The key decision issued after the conference is to recommend intrapartum antimicrobial prophylaxis based on a universal intrapartum GBS screening strategy using a rapid real time testing.

show abstract

Cost‐effectiveness of rapid tests and other existing strategies for screening and management of early‐onset group B streptococcus during labour

Cited by 31 publications

References 28 publications

Prevalence of maternal group B streptococcus colonization and vertical transmission in low-risk women in a single institute

Prevalence of maternal group B streptococcus colonization and vertical transmission in low-risk women in a single institute

Molecular-based Screening for Perinatal Group B Streptococcal Infection: Implications for Prevention and Therapy

Intrapartum GBS screening and antibiotic prophylaxis: a European consensus conference

Contact Info

Product

Resources

About