Prevention of perinatal group B streptococcal disease: screening practice in public hospitals in Victoria.
OBJECTIVE
To survey clinical protocols for prevention of early-onset group B streptococcal disease (EOGBSD) of the newborn in public maternity hospitals.


METHODS
Postal questionnaire with telephone follow-up when required.


METHODS
All hospitals that undertook deliveries in public patients in the State of Victoria, November 1997 to January 1998.


RESULTS
The survey was sent to 84 hospitals: 71 responded and 64 met the criteria and provided usable data (76% response rate). These 64 represented 42,784 births (68% of births in Victoria in 1996). Most hospitals (62; 97%) undertook actions that would identify and treat pregnant women at risk of EOGBSD. 48 (75%) performed bacteriological screening for maternal GBS carriage, but only 20 of these had a unified protocol. Screening was mostly by low vaginal swab (15 hospitals) and before 30 weeks' gestation (12 hospitals). Low vaginal swab plus anal swab was used in only one hospital. Bacteriological screening was significantly more common in metropolitan hospitals than in rural hospitals (100% versus 67%; P = 0.007, Fisher's exact test). Targeting of prophylaxis by recognised risk factors was reported by 59 (92%) hospitals, 45 of which also undertook screening. There was considerable variation in the specific risk factors used.


CONCLUSIONS
While there was clearly widespread awareness of EOGBSD in Victorian public hospitals, prevention programs varied considerably. The development of consensus practice guidelines might improve EOGBSD prevention, reducing morbidity, mortality and costs.
Connellan
M
M
Monash Medical Centre, Melbourne, VIC.
Wallace
E M
EM
D019072:Antibiotic Prophylaxis; D003362:Cost-Benefit Analysis; D003625:Data Collection; D005260:Female; D006771:Hospitals, Maternity / Q000191:economics / Q000706:statistics & numerical data*; D006780:Hospitals, Rural; D006786:Hospitals, Urban; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D008403:Mass Screening / Q000191:economics / Q000706:statistics & numerical data*; D011247:Pregnancy; D011295:Prenatal Care / Q000379:methods; D012307:Risk Factors; D013290:Streptococcal Infections / Q000151:congenital* / Q000191:economics / Q000453:epidemiology / Q000517:prevention & control*; D013292:Streptococcus agalactiae; D014739:Victoria / Q000453:epidemiology