Changes in early-onset group B beta hemolytic streptococcus disease with changing recommendations for prophylaxis.
OBJECTIVE
To determine the incidence of early-onset group B beta hemolytic streptococcal (EOGBS) infection and the association between changes in the incidence and intrapartum antibiotic prophylaxis (IAP).


METHODS
A retrospective population survey of infants with GBS at < 7 days of age with a nested case-control study of non-GBS infants over the same time period, January 1985 to December 1998. The incidence of GBS and maternal antibiotic treatment during labor was analyzed as a function of time period: prior to publication of guidelines for prevention of EOGBS (1985-1992), following AAP/ACOG guidelines (1993-1995), and following CDC consensus guidelines (1996-1998).


RESULTS
Fifty-six cases of EOGBS infection occurred among 53,088 live births. The incidence declined from 1.5/1000 before any guidelines to 0.67/1000 after AAP/ACOG guidelines (p = 0.004), and continued to decline after the CDC consensus statement (0.28/1000) (p = 0.38). IAP remained stable (33% of at risk mothers) until after introduction of the CDC consensus guidelines (59%, p = 0.02).


CONCLUSIONS
IAP did not fully explain the decline in EOGBS incidence in our center.
D017668:Age of Onset; D019072:Antibiotic Prophylaxis; D016022:Case-Control Studies; D003428:Cross Infection / Q000188:drug therapy / Q000453:epidemiology* / Q000517:prevention & control*; D005260:Female; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D008297:Male; D009518:New York / Q000453:epidemiology; D012307:Risk Factors; D013290:Streptococcal Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000517:prevention & control*; D013292:Streptococcus agalactiae