Infections of GBS's etiology and use of perinatal antibiotic prophylaxis
More details
Hide details
Chair and Department of Obstetrics and Pathology of Pregnancy, Pomeranian Medical University, Szczecin, Poland
Obstetrics and Gynecology Ward of SPZOZ Hospital, Kołobrzeg, Poland
Department of Obstetrics and Gynecology, Pomeranian Medical University, Szczecin, Poland
Independent Unit of Obstetric Skills, Pomeranian Medical University, Szczecin, Poland
Sławomir Szymański   

Zakład Położnictwa i Patologii Ciąży Pomorski Uniwersytet Medyczny, Żołnierska 48, 71-210 Szczecin, Poland
J Pre Clin Clin Res. 2018;12(2):54–58
A significant decline in the proportion of perinatal mortality of foetuses and newborns have been reported in recent years. Despite the tremendous progress made in the field of perinatal care, there is still a risk of infection of the foetus during pregnancy or its birth.

The aim of the study was to assess the effectiveness of an antibiotic prophylaxis in order to reduce perinatal percentage of early-symptomatic infections in newborn infants.

Material and methods:
Material for the study was obtained from the medical records of 1,328 live born individual infants and their mothers. Tested continuous parameters were described with the appropriate numbers, arithmetic mean, standard deviation, median and minimum and maximum values. For analysis of fractions the Chi square was used; also with Yates correction (for a small number of cells). Level of statistical significance – p<0.05.

The duration of pregnancy in mothers who gave birth to newborns without evidence of GBS infection was significantly longer than the duration of pregnancy in mothers whose infants were infected with Group B streptococcus (GBS) (39.2 vs 38.3 weeks gestation). In 13 infants infected during delivery, antibiotic prophylaxis was not used (92.86%), while it was used in only one case (7.14%). Perinatal prophylaxis was used in 26.81% of the surveyed mothers.

Kotarski J, Heczko PB, Lauterbach R, Niemiec T, Leszczyńska-Gorzelak B. Rekomendacje Polskiego Towarzystwa Ginekologicznego dotyczące wykrywania nosicielstwa paciorkowców grupy B (GBS) u kobiet w ciąży i zapobiegania zakażeniom u noworodków. Ginekol Pol. 2008; 79: 221–223.
Centers for Disease Control and Prevention (CDC). Perinatal group B streptococcal disease after universal screening recommendations- United States, 2003–2005. MMWR Morb Mortal Wkly Rep 2007; 56: 701–705.
Barcaite E, Bartusevicius A, Tameliene R, Kliucinskas M, Maleckiene L, Nadisauskiene R. Prevalence of maternal group B streptococcal colonisation in European countries. Acta Obstet Gynecol Scand. 2008; 87(3): 260–271.
Pettersson KS. Perinatal infection with group B sterptococci. Semin Fetal Neonatal Med. 2007; 12: 193–197.
Boyer KM, Gadzala CA. Selective intrapartum chemoprophylaxis of neonatal group B streptococcal early-onset disease. I Epidemiologic rationale. J Infect Dis. 1983; 148: 795–801.
Baltimore RS. Consequences of prophylaxis for group B streptococcal infections of the neonate. Semin Perinatol. 2007; 31: 33–38.
Renner RM, Renner A, Schmid S, Hoesli I, Nars P, Holzgreve W, [et al.]. Efficacy of a strategy to prevent neonatal early-onset group B streptococcal (GBS) sepsis. J Perinat Med. 2006; 34: 32–38.
Centers for Disease Control and Prevention (CDC). Trends in perinatal group B streptococcal disease-United States, 2000–2006. MMWR Morb Mortal Wkly Rep. 2009; 58: 109–112.
Velaphi S, Siegel J, Wendel G. Early-Onset Group B Streptococcal Infection After a Combined Maternal and Neonatal Group B Streptococcal Chemoprophylaxis Strategy. Pediatrics. 2003; 111: 541–547.
Puopolo KM, Madoff LC, Eichenwald EC. Early-onset group B streptococcal disease in the era of maternal screening. Pediatrics. 2005; 115: 1240–1246.
Schrag SJ, Verani JR. Intrapartum antibiotic prophylaxis for the prevention of perinatal group B streptococcal disease, experience in the United States and implications for a potential group B streptococcal vaccine. Vaccine. 2013; 31(4): D20-26.
Valkenburg-van den Berg AW, Houtman- Roelofsen RL, Oostvogel PM, Dekker FW, Dörr PJ, Sprij AJ. Timing of group B streptococcus screening in pregnancy, a systematic review. Gynecol Obstet Invest. 2010; 69: 174–183.
Berardi A, Lugli L, Baronciani D, Rossi C, Ciccia M, Creti R. GBS Prevention Working Group of Emilia-Romagna. Group B Streptococcus early-onset disease in Emilia-Romagna, review after introduction of a screening-based approach. Pediatr Infect Dis J. 2010; 29: 115–121.
Boyer KM, Gadzala CA, Burd LI, Fisher DE, Paton JB, Gotoff SP. Selective intrapartum chemoprophylaxis of neonatal group B Streptococcal early-onset disease. J Infect Dis. 1983; 148: 802–809.
Assefa S, Desta K, Lema T. Group B streptococci vaginal colonization and drug susceptibility pattern among pregnant women attending in selected public antenatal care centers in Addis Ababa, Ethiopia. BMC Pregnancy Childbirth. 2018; 18:135.
Feng-Ying C, Leonard EW, Parvin A, Young AE, Chang K, Cielo M, [et al.]. Assessment of Intrapartum Antibiotic Prophylaxis for the Prevention of Early-onset Group B Streptococcal Disease. Pediatr Infect Dis J. 2011; 30: 759–763.
Bauserman MS, Laughon MM, Hornik CP, Smith PB, Benjamin Jr. DK, Clark RH, [et al.]. Evaluation of Universal Antenatal Screening for Group B Streptococcus. N Engl J Med. 2009; 360: 2626–2636.
Pulver LS, Hopfenbeck MM, Young PC, Stoddard GJ, Korgenski K, Daly J. Continued early onset group B streptococcal infections in the era of intrapartum prophylaxis. J Perinatol. 2009; 29: 20–25.
El Helali N, Nguyen JC, Ly A, Giovangrandi Y, Trinquart L. Diagnostic accuracy of a rapid real-time polymerase chain reaction assay for universal intrapartum group B streptococcus screening. Clin Infect Dis. 2009; 49: 417–423.
Honest H, Sharma S, Khan KS. Rapid tests for group B Streptococcus colonization in laboring women, a systematic review. Pediatrics. 2006; 117: 1055–1066.
Money D, Dobson S, Cole L, Karacabeyli E, Blondel-Hill E, Milner R, [et al.]. An evaluation of a rapid real time polymerase chain reaction assay for detection of group B streptococcus as part of a neonatal group B streptococcus prevention strategy. J Obstet Gynaecol Can. 2008; 30: 770–775.
Ohlsson A, Shah V. Intrapartum antibiotics for known maternal Group B streptococcal colonization. Cochrane Database Syst Rev. 2009; 3, CD007467.
Regan JA, Klebanoff MA, Nugent RP. The epidemiology of group B streptococcal colonization in pregnancy. Vaginal infections and Prematurity Study Group. Obstet Gynecol. 1991; 77: 604–610.
Hung L, Kung PT, Chiu TH, Su HP, Ho M, Kao HF, [et al]. Risk factors for neonatal early-onset group B streptococcus-related diseases after the implementation of a universal screening program in Taiwan. BMC Public Health 2018; 18: 438.
Hickman ME, Rench MA, Ferrieri P, Baker CJ. Changing epidemiology of group B streptococcal colonization. Pediatrics. 1999; 104: 203–209.
Hansen R, Gibson S, Alves E, Goddard M, MacLaren A, Karcer AM, [et al.] Adaptive response of neonatal sepsis-derived Group B Streptococcus to bilirubin. Sci Rep. 2018; 8: 6470.
Hijona JJ, Carballo AL, Sanchez MS, Dyachkova N, Exposito JF, Alcazar JL. Vaginal antiseptics reduce the risk of perinatal infection with group B streptococci. J Matern Fetal Neonatal Med. [published online 26apr 2018] DOI: 10.1080/14767058.2018.1449196.