The efficacy of 2002 CDC guidelines in preventing perinatal group B Streptococcal vertical transmission: a prospective study.
OBJECTIVE
The aim of the current study is to evaluate the differences in the rate of perinatal group B streptococcal vertical transmission between women who correctly underwent the CDC 2002 guidelines and women who did not.


METHODS
Two study groups: women who correctly underwent the CDC 2002 guidelines (study group 1) and women who did not (study group 2). Intrapartum chemoprophylaxis (IC) was administered to all pregnant women identified as GBS carrier. All newborns received, in the first hour of life, a culture based screening for GBS colonization.


RESULTS
One thousand six hundred and sixty nine women were enrolled in the study. The 2002 CDC guidelines were correctly applied in 1273 (76.3%) subjects. There was no early-onset GBS disease. No statistically significant difference in the total number of colonized newborns between study group 1 (4.1%) and study group 2 (3.3%) was found. When the analysis was limited to women with positive GBS screening, a significant difference (P < 0.001) was observed in the number of colonized newborns between mothers who received IC during at least 4 h (group 1; 3.7%) and those who received an IC during less than 4 h (group 1; 12.3%).


CONCLUSIONS
The accurate application of the 2002 CDC guidelines is strongly supported but, to furthermore reduce the risk for GBS colonization and sepsis in the newborns, it appears desirable to identify additional and new prevention strategies.
Lijoi
Davide
D
Department of Obstetrics and Gynaecology, San Martino Hospital, University of Genoa, Largo R. Benzi 10, 16132 Genoa, Italy. davide.lijoi@libero.it
Di Capua
Elisa
E
Ferrero
Simone
S
Mistrangelo
Emanuela
E
Giannattasio
Alessandro
A
Morano
Sandra
S
Ragni
Nicola
N
D000293:Adolescent; D000328:Adult; D000667:Ampicillin / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002353:Carrier State; D002437:Cefazolin / Q000627:therapeutic use; D002487:Centers for Disease Control and Prevention, U.S.; D018890:Chemoprevention; D002981:Clindamycin / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D007558:Italy; D015997:Neonatal Screening; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000382:microbiology* / Q000517:prevention & control; D011446:Prospective Studies; D012007:Rectum / Q000382:microbiology; D013290:Streptococcal Infections / Q000175:diagnosis / Q000517:prevention & control* / Q000635:transmission*; D013292:Streptococcus agalactiae; D014481:United States; D014621:Vagina / Q000382:microbiology; D014640:Vancomycin / Q000627:therapeutic use
D000900:Anti-Bacterial Agents; D002981:Clindamycin; D014640:Vancomycin; D000667:Ampicillin; D002437:Cefazolin