title: Replacing risk-based early-onset-disease prevention with intrapartum group B streptococcus PCR testing.
abstract: OBJECTIVE
  To evaluate the effect of a rapid PCR-based group B streptococcus (GBS) test on length of stay in hospital among newborns, antibiotic use, and GBS-early-onset-disease (EOD) incidence.
  
  
  METHODS
  We conducted a before and after service evaluation including term deliveries between 1st January and 12th November 2014 (6688 deliveries). Length of stay in the hospital, GBS-EOD incidence and antibiotic use were evaluated.
  
  
  RESULTS
  We recorded three confirmed and 74 possible cases of GBS-EOD in Phase 1, and 85 possible cases in Phase 2. In newborns with suspected infection, the introduction of the rapid test was related to a decreased length of stay on the pediatric care unit by 1.16 days (p = 0.01), and an increase in the length of stay on the mother-and-baby ward by 1.11 days (p < 0.001). No increase in antibiotics was noted.
  
  
  CONCLUSIONS
  The introduction of a point of care test was associated with a reduction in length of stay in the pediatric care unit, without an increase in antibiotic use. This test could improve the accuracy of GBS colonization detection, and help to prevent intrapartum transmission as no verified GBS-EOD cases were recorded with the intrapartum PCR algorithm.
authors.affiliation: a Children's Hospital, University of Helsinki and Helsinki University Hospital , Helsinki , Finland , and.
authors.forename: V
authors.initials: V
authors.lastname: Björklund
authors.affiliation: a Children's Hospital, University of Helsinki and Helsinki University Hospital , Helsinki , Finland , and.
authors.forename: T
authors.initials: T
authors.lastname: Nieminen
authors.affiliation: b Department Of Obstetrics and Gynecology , University of Helsinki and Helsinki University Hospital , Helsinki , Finland.
authors.forename: V M
authors.initials: VM
authors.lastname: Ulander
authors.affiliation: a Children's Hospital, University of Helsinki and Helsinki University Hospital , Helsinki , Finland , and.
authors.forename: T
authors.initials: T
authors.lastname: Ahola
authors.affiliation: a Children's Hospital, University of Helsinki and Helsinki University Hospital , Helsinki , Finland , and.
authors.forename: H
authors.initials: H
authors.lastname: Saxén
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D019072:Antibiotic Prophylaxis; D005260:Female; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D007902:Length of Stay / Q000706:statistics & numerical data; D010400:Penicillin G / Q000627:therapeutic use; D018743:Perinatal Care / Q000379:methods*; D019095:Point-of-Care Systems; D016133:Polymerase Chain Reaction; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis* / Q000453:epidemiology / Q000517:prevention & control; D018570:Risk Assessment; D013290:Streptococcal Infections / Q000175:diagnosis* / Q000453:epidemiology / Q000517:prevention & control / Q000635:transmission; D013292:Streptococcus agalactiae / Q000235:genetics / Q000302:isolation & purification*; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D010400:Penicillin G
keywords: GBS early onset disease; group B streptococcus; neonates; observational study; rapid diagnostic test