Effect of a screening-based prevention policy on prevalence of early-onset group B streptococcal sepsis.
OBJECTIVE
To assess the effectiveness and feasibility of implementing the Centers for Disease Control and Prevention (CDC) screening-based guidelines for preventing early-onset group B streptococcal sepsis.


METHODS
We compared prevalence of early-onset group B streptococcal sepsis after institution of the CDC screening-based protocol (October 1, 1995 through August 31, 1999) with that of historical controls (January 1, 1992 through June 30, 1995). We reviewed medical records for a cohort of deliveries of at least 23 weeks' gestation (January 1, 1996 through December 31, 1996) for group B streptococcal colonization status, risk factors, and intrapartum antibiotic prophylaxis.


RESULTS
The prevalence of early-onset group B streptococcal sepsis was 1.16 per 1000 (36 of 31, 133) live births before and 0.14 per 1000 (four of 28,733) live births after institution of the CDC protocol (P <.001). Maternal colonization was known for 95.3% of the 7168 women who delivered (January 1, 1996 through December 31, 1996) at or after 37 weeks' gestation. Of 2174 women who qualified for intrapartum antibiotic prophylaxis, 1871 (86.1%) received it before delivery. There was 93. 8% compliance with intrapartum antibiotic prophylaxis for women who delivered vaginally and 53.2% compliance for women who delivered by cesarean.


CONCLUSIONS
Institution of the CDC screening-based protocol was accomplished at a specialty women's hospital, staffed by full-time faculty and community physicians, with 93.8% compliance for vaginal deliveries, and was associated with an 88% reduction in early-onset group B streptococcal sepsis.
Brozanski
B S
BS
Division of Neonatology and Developmental Biology, Department of Pediatrics, University of Pittsburgh and Magee-Womens Research Institute, Pittsburgh, PA 15213, USA. bbrozanski@mail.magee.edu
Jones
J G
JG
Krohn
M A
MA
Sweet
R L
RL
D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008403:Mass Screening; D008875:Middle Aged; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology / Q000517:prevention & control*; D015995:Prevalence; D013290:Streptococcal Infections / Q000453:epidemiology / Q000517:prevention & control*; D013292:Streptococcus agalactiae
D000900:Anti-Bacterial Agents