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Neonatal group B streptococcal disease: Prevention

Author
Carol J Baker, MD
Section Editors
Susan M Ramin, MD
Daniel J Sexton, MD
Deputy Editor
Vanessa A Barss, MD, FACOG

INTRODUCTION

Group B Streptococcus (GBS or Streptococcus agalactiae) is an encapsulated gram-positive coccus that colonizes the gastrointestinal and genital tracts of 15 to 40 percent of pregnant women [1]. Although GBS colonization usually remains asymptomatic in these women, maternal colonization is the critical determinant of infection in neonates and young infants (less than 90 days of age), in whom GBS is the most common cause of bacterial infection [2,3]. Vertical (mother-to-child) transmission primarily occurs when GBS ascends from the vagina to the amniotic fluid after onset of labor or rupture of membranes, but can occur with intact membranes [4,5].

In the mid-1980s, randomized and controlled clinical trials demonstrated that intrapartum administration of intravenous penicillin or ampicillin to GBS carriers protected their newborns from developing early-onset disease (ie, GBS infection at 0 to 6 days of age) [6-8]. Based upon this evidence, the Centers for Disease Control and Prevention (CDC) published guidelines for prevention of neonatal GBS disease in 2002 [4] and 2010 [3]. The key intervention of these guidelines is intrapartum parenteral antibiotic prophylaxis of women whose infants are at high risk of developing early-onset GBS infection because a maternal GBS culture was positive in the weeks before delivery or because of maternal characteristics that increase the risk of early-onset GBS disease in their offspring.

The 2010 CDC guidelines for prevention of early-onset GBS disease will be reviewed here. These guidelines have been endorsed by the American College of Obstetricians and Gynecologists [9] and the American Academy of Pediatrics [10]. The microbiology, epidemiology, clinical manifestations, and treatment of perinatal and adult GBS infections, and the status of GBS vaccines are discussed separately:

(See "Group B streptococcal infection in pregnant women".)

(See "Management of the infant whose mother has received group B streptococcal chemoprophylaxis".)

                                

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Literature review current through: Nov 2016. | This topic last updated: Wed Feb 10 00:00:00 GMT 2016.
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