Reduction of morbidity and mortality rates for neonatal group B streptococcal disease through early diagnosis and chemoprophylaxis

Abstract

Pregnant women, part of the term service population at Orlando Regional Medical Center, were screened for group B streptococci (GBS), using Lim Group B Strep Broth (GIBCO Laboratories, Madison, Wis.) and the Phadebact Strep B Test (Pharmacia Diagnostics, Piscataway, N.J.). Of the 803 women screened, 173 were confirmed as colonized with GBS at the time of admission in labor. Eighty of these women were treated with ampicillin at least 6 h prior to delivery. The remaining 93 women received no ampicillin. None of the infants born to the treated women was colonized with GBS at surface culture sites. Forty-three of the infants born to untreated women were colonized. Rapid identification of GBS colonization in women, combined with ampicillin chemoprophylaxis, significantly reduced vertical transmission of GBS.

Group B streptococcus: rapid intraparturn detection and influence of density of maternal colonization on vertical transmission

“…It is widely accepted that heavy colonization of the mother is a risk factor for GBS infection, but light colonization can lead to GBS infection, as in some of our cases and as previously reported by Lim et al [10] and Towers et al [11]. The results can be explained in two ways: either the CFU count is artificially decreased by the ‘wash‐out’ phenomenon when samples are taken shortly after rupture of fetal membranes, or early‐onset disease may be due to GBS strains with particular pathogenicity or other risk factors.…”

Morbidity related to maternal group B streptococcal infections

“…Studies on GBS transmission in colonized mothers during delivery report incidences between 16 and 53% (39–42) and neonatal disease develops with a frequency of 1% (40) to 22% (39) in colonized neonates. Only 1–2% of infants of colonized women develop early‐onset GBS disease in the first week of life.…”

The IgA‐binding β antigen of the c protein complex of Group B streptococci: sequence determination of its gene and detection of two binding regions

“…Group B Streptococcus (GBS; Streptococcus agatactiae) causes respiratory distress, sepsis and meningitis in newborn infants, and is associated with one of the highest neonataf mortality rates resulting from any bacterial disease (Lim et at., 1986). More recently, GBS has been found to cause neonatal osteomyelitis and is associated with premature rupture of membranes and preterm delivery (Baxter and Finnegan, 1988;Matorras et ai, 1989).…”