title: Prevention of early-onset Group B Streptococcal disease - the Northern Ireland experience.
abstract: OBJECTIVE
  To ascertain guideline adherence for prevention of Group B Streptococcal (GBS) neonatal infection and establish prevalence and outcomes in Northern Ireland (NI).
  
  
  METHODS
  Retrospective observational study.
  
  
  METHODS
  Northern Ireland maternity units.
  
  
  METHODS
  Using NI Health Information Systems the following were identified: (1) a cohort of women with one or more risk factors for GBS disease in 2009-2010, (2) all culture-positive cases of GBS in babies aged 0-89 days (2008-2010), (3) stillbirths due to GBS (2009-2010).
  
  
  METHODS
  Information was analysed for a 15% randomised sample of the available cases. Maternal and infant case notes were reviewed for confirmed cases of neonatal early onset GBS (EOGBS) during 2008-2010.
  
  
  METHODS
  Adherence to the 2003 RCOG guideline on prevention of GBS disease (2009-2010). Number of neonatal GBS infections: antenatal risk factors, management and neonatal outcomes (2008-2010). The number of stillbirths related to GBS (2009-2010).
  
  
  RESULTS
  Five hundred and seventy-four women had one or more identifiable risk factors for GBS disease; intrapartum antibiotic prophylaxis (IAP) was administered in 42% of cases. Improved administration of IAP was noted in the presence of escalating risk factors. At best, guideline adherence was 50-70%. Forty-three neonates had proven early-onset Group B Streptococcal disease; 55.8% had maternal risk factors. Of the total identified cases, 25.5% received IAP. The total mortality rate was 11.46%. The incidence of EOGBS disease in NI was 0.57/1000 live births.
  
  
  CONCLUSIONS
  Prevalence of EOGBS is higher in NI than the UK as a whole. Risk factors are present in 55.8% of mothers; IAP does not prevent all cases of EOGBS.
authors.affiliation: Department of Obstetrics and Gynaecology, Antrim Area Hospital, Antrim, County Antrim, UK.
authors.forename: K A
authors.initials: KA
authors.lastname: Eastwood
authors.forename: S
authors.initials: S
authors.lastname: Craig
authors.forename: H
authors.initials: H
authors.lastname: Sidhu
authors.forename: M
authors.initials: M
authors.lastname: Boyle
authors.forename: C
authors.initials: C
authors.lastname: Gannon
authors.forename: G
authors.initials: G
authors.lastname: Ong
authors.forename: M
authors.initials: M
authors.lastname: Lupari
authors.forename: A
authors.initials: A
authors.lastname: Craven
authors.forename: S
authors.initials: S
authors.lastname: Magowan
authors.forename: R G
authors.initials: RG
authors.lastname: Ashe
mesh_terms: D000328:Adult; D019072:Antibiotic Prophylaxis / Q000706:statistics & numerical data*; D005260:Female; D019983:Guideline Adherence; D006771:Hospitals, Maternity; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control* / Q000706:statistics & numerical data; D008297:Male; D008826:Microbial Sensitivity Tests; D009660:Northern Ireland / Q000453:epidemiology; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis / Q000188:drug therapy / Q000517:prevention & control*; D012189:Retrospective Studies; D012307:Risk Factors; D050497:Stillbirth / Q000453:epidemiology; D013290:Streptococcal Infections / Q000175:diagnosis / Q000188:drug therapy / Q000517:prevention & control*; D013292:Streptococcus agalactiae / Q000302:isolation & purification*
keywords: Anaphylaxis; Group B Streptococcal disease; intrapartum antibiotic prophylaxis; neonatal infection