[Prevention of early-onset group B Streptococcus infections. 2. Efficiency of the ANAES guidelines].
OBJECTIVE
To examine the efficiency on early-onset neonatal infections of the ANAES guidelines for early-onset infections prophylaxis, based on a systematic prenatal vaginal swab aiming Group B Streptococcus and/or infection risk factors during delivery.


METHODS
This is a retrospective cohort study of early-onset infections during a period of 28 months (6125 deliveries) compared to an earlier period (6141 deliveries).


RESULTS
The number of newborns admitted for suspected infection and the rate of sepsis have been unchanged. But the total number of infections has decreased (1.50 vs 2.02 %, p=0,024), without increase of the number of infections due to other germs such as Escherichia coli. Furthermore, a strategy based only on risk factors would not have allowed the early screening and treatment of 23 Streptococcus B infected newborns.


CONCLUSIONS
We have proved the efficiency of the protocol in terms of prevention of early-onset infections. However, it has led to a dramatic increase in the consumption of antibiotics, which is worrying concerning maternal and neonatal bacterial ecology.
Muris
C
C
Service de gynécologie-obstétrique et médecine de la reproduction, CHU, boulevard Georges-Clémenceau, 14033 Caen cedex, France. murisguillou@free.fr
Lemonnier
M
M
Herlicoviez
M
M
Dreyfus
M
M
D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D015331:Cohort Studies; D005260:Female; D005602:France; D006291:Health Policy; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy; D012189:Retrospective Studies; D013290:Streptococcal Infections / Q000453:epidemiology / Q000517:prevention & control* / Q000635:transmission*; D013292:Streptococcus agalactiae / Q000302:isolation & purification
D000900:Anti-Bacterial Agents