Culture-based group B streptococcal screening. Adherence to current guidelines.
OBJECTIVE
To examine the ability of a universal screening strategy to identify and treat group B Streptococcus-positive women with intrapartum antibiotics.


METHODS
Charts were reviewed on all patients delivering at > or = 36 weeks of gestation as to the presence of culture results, whether or not antibiotics were ordered and when they were given relative to the time of delivery.


RESULTS
Approximately 95% of patients presenting at > or = 36 weeks had group B Streptococcus results available. Overall, 84% of culture-positive patients received chemoprophylaxis. Removal of the elective cesareans from the study population increased the percentage of positive patients receiving antibiotics to 94%. Ideal chemoprophylaxis, defined as delivering > or = 2 hours after receiving the recommended antibiotics, occurred 87% of the time. Failure to order appropriate antibiotics was the most frequent reason for not receiving chemoprophylaxis.


CONCLUSIONS
Successful universal culturing followed by intrapartum chemoprophylaxis can be accomplished in a majority of cases. Failure to treat can occur (6%), and chemoprophylaxis may be less than ideal (13%) due to rapid labor and human error.
Pinette
Michael G
MG
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Maine Medical Center, Portland, ME 04102, USA. cartia@mmc.org
Wax
Joseph R
JR
Blackstone
Jacquelyn
J
Cartin
Angelina
A
McCrann
Donald J
DJ
D000328:Adult; D019072:Antibiotic Prophylaxis; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control; D008403:Mass Screening; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis* / Q000517:prevention & control*; D012189:Retrospective Studies; D013290:Streptococcal Infections / Q000175:diagnosis*; D013291:Streptococcus / Q000302:isolation & purification* / Q000472:pathogenicity