Group B streptococci: Results of a protocol of antepartum screening and intrapartum treatment

• Published in: American journal of obstetrics and gynecology Vol. 170; no. 2; pp. 521 - 526
• Main Authors: Katz, Vern L., Moos, Merry-K., Cefalo, Robert C., Thorp, John M., Bowes, Watson A., Wells, Sara D.
• Format: Journal Article
• Language: English
• Published: Philadelphia, PA Elsevier Inc 01.02.1994; Elsevier
• Subjects: Ampicillin - therapeutic use; antepartum screening; Biological and medical sciences; Carrier State - diagnosis; Carrier State - drug therapy; Carrier State - microbiology; Cefazolin - therapeutic use; Chorioamnionitis - drug therapy; Clindamycin - therapeutic use; Clinical Protocols; Diseases of mother, fetus and pregnancy; Female; Group B streptococci; Gynecology. Andrology. Obstetrics; Humans; Infant, Newborn; Injections, Intravenous; Medical sciences; Obstetric Labor Complications - drug therapy; perinatal infection; Pregnancy; Pregnancy Complications, Infectious - diagnosis; Pregnancy Complications, Infectious - drug therapy; Pregnancy Complications, Infectious - microbiology; Pregnancy Complications, Infectious - prevention & control; Pregnancy. Fetus. Placenta; Rectum - microbiology; Streptococcal Infections - diagnosis; Streptococcal Infections - drug therapy; Streptococcal Infections - microbiology; Streptococcal Infections - prevention & control; Streptococcus agalactiae - isolation & purification; Vagina - microbiology; Group B streptococci; antepartum screening; perinatal infection; Human; Medical screening; Infection; Pregnancy; Prevention; Streptococcaceae; Newborn; Treatment; Efficiency; Streptococcal infection; Streptococcus B; Bacteriosis; Bacteria; Micrococcales
• ISSN: 0002-9378; 1097-6868
• DOI: 10.1016/S0002-9378(94)70221-7

OBJECTIVE: Our purpose was to evaluate and report the results of a protocol for the identification and treatment of all group B streptococcal carriers. STUDY DESIGN: In 1991 we instituted a protocol of antepartum cultures for group B streptococci on all pregnant women who attended clinics at the University of North Carolina Hospitals. Cultures were obtained from the lower third of the vagina and rectum at 24 to 28 weeks' gestation. Women with positive cultures were treated with intravenous antibiotics in labor. Women with signs of chorioamnionitis (through intrapartum assessment) were also treated in labor, regardless of carrier status. RESULTS: During the first 2 years of this protocol 1681 women were delivered. Forty percent of the women were from the private practice, 32% were black, and 62% were married. The group B streptococcal carriage rate was 14%. During the period of evaluation there were no infants infected with group B streptococci and no adverse reactions or complications among women who were treated with antibiotics. CONCLUSION: We found antepartum screening and intrapartum chemoprophylaxis of all group B streptococcal carriers to be an acceptable and effective protocol for reducing perinatal group B streptococcal infections. (AM J OBSTET GYNECOL 1994;170:521-6.)