Compliance with the Centers for Disease Control and Prevention antenatal culture protocol for preventing group B streptococcal neonatal sepsis.
OBJECTIVE
Our purpose was to measure the compliance with the Centers for Disease Control and Prevention antenatal culture protocol for preventing group B streptococcal sepsis after extensive education of physicians and staff.


METHODS
After 2 months of educational activities to familiarize attending physicians, nurses, and laboratory staff with the guidelines, a retrospective chart review of all vaginal deliveries over a 6-month period were analyzed for protocol compliance and failures either of culturing or antibiotic use.


RESULTS
Overall, there was a 20% prevalence rate of group B streptococci found at > or = 35 weeks' gestation. The enhanced broth preincubation did not significantly increase this rate. Compliance with the protocol was 80% for appropriately timed cultures and 84% for use of antibiotics; 0.7% received unindicated antibiotics.


CONCLUSIONS
The area of greatest compliance failure was neglecting to treat women with antepartum risk factors that did not require antepartum cultures: previously affected neonates with group B streptococcal sepsis, antepartum group B streptococcal bacteriuria, and preterm labor and delivery. Twenty-one percent (14/66) of women having these antepartum risk factors were not treated. Protocol failure resulting in no cultures being done occurred in 9% of the women studied (87/956). Further education and quality assurance activities can lower these numbers. There were no cases of group B streptococcal sepsis during the 6 months of this study.
Cheon-Lee
E
E
Department of Obstetrics and Gynecology, Genesee Hospital and University of Rochester School of Medicine and Dentistry, New York, USA.
Amstey
M S
MS
D001431:Bacteriological Techniques; D002487:Centers for Disease Control and Prevention, U.S. / Q000592:standards*; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D007231:Infant, Newborn; D009775:Obstetrics and Gynecology Department, Hospital; D011247:Pregnancy; D011296:Prenatal Diagnosis / Q000379:methods*; D015995:Prevalence; D018805:Sepsis / Q000453:epidemiology / Q000382:microbiology / Q000517:prevention & control*; D013290:Streptococcal Infections / Q000453:epidemiology / Q000517:prevention & control*; D013292:Streptococcus agalactiae; D014481:United States / Q000453:epidemiology