Outcome of a screening programme for the prevention of neonatal invasive early onset group B Streptococcus infection in a UK maternity unit: an observational study
File(s)
Published version
Author(s)
Type
Journal Article
Abstract
Background: Against a background of failure to prev
ent neonatal invasive early-onset group B
Streptococcus
infections (GBS) in our maternity unit using risk-
based approach for intrapartum antibiotic prophylax
is, we introduced an antenatal GBS carriage screening programme to identify additional women to target for prophylaxis.
Objectives: To describe the implementation and outc
ome of an antepartum
screening programme for prevention of invasive earl
y-onset GBS infection in a
UK maternity unit.
Design: Observational study of outcome of screenin
g programme (intervention)
with comparison to historical controls (pre-interve
ntion).
Setting: Hospital and community-based maternity ser
vices provided by Northwick Park and Central Middlesex Hospitals in northwest London
Participants: Women who gave birth between March 20
14-December 2015 at Northwick Park Hospital.
Methods: Women were screened for GBS at 35-37 weeks
and carriers offered
intrapartum antibiotic prophylaxis. Screening progr
amme was first introduced in hospital(March 2014) and then in community(August 2
014). Compliance was audited by review of randomly selected case records. Invasive early-onset GBS infections was defined through GBS being cultured from neonatal blood, cerebrospinal fluid or sterile fluids within 0-6 da
ys of birth,
Main outcome: Incidence of early onset GBS infections.
Results: 6309 (69%) of the 9098 eligible women were
tested. Screening rate
improved progressively from 42% in 2014 to 75% in 2
015. Recto-vaginal GBS
carriage rate was 29.4% (1822/6193). All strains we
re susceptible to penicillin but 11.3% (206/1822) were resistant to clindamycin.
Early-onset GBS rate fell from 0.99/1000 live births (25/25276) in the pre-screening period to 0.33/1000 in the screening period (Rate Ratio=0.33; p=0.08) I
n the subset of mothers actually screened, the rate was 0.16/1000 live birt
hs (1/6309), (Rate Ratio = 0.16; p<0.05).
Conclusions
Our findings confirm that an antenatal screening pr
ogramme for prevention of early onset GBS infection can be implemented in a UK maternity setting and is associated with a fall in infection rates.
ent neonatal invasive early-onset group B
Streptococcus
infections (GBS) in our maternity unit using risk-
based approach for intrapartum antibiotic prophylax
is, we introduced an antenatal GBS carriage screening programme to identify additional women to target for prophylaxis.
Objectives: To describe the implementation and outc
ome of an antepartum
screening programme for prevention of invasive earl
y-onset GBS infection in a
UK maternity unit.
Design: Observational study of outcome of screenin
g programme (intervention)
with comparison to historical controls (pre-interve
ntion).
Setting: Hospital and community-based maternity ser
vices provided by Northwick Park and Central Middlesex Hospitals in northwest London
Participants: Women who gave birth between March 20
14-December 2015 at Northwick Park Hospital.
Methods: Women were screened for GBS at 35-37 weeks
and carriers offered
intrapartum antibiotic prophylaxis. Screening progr
amme was first introduced in hospital(March 2014) and then in community(August 2
014). Compliance was audited by review of randomly selected case records. Invasive early-onset GBS infections was defined through GBS being cultured from neonatal blood, cerebrospinal fluid or sterile fluids within 0-6 da
ys of birth,
Main outcome: Incidence of early onset GBS infections.
Results: 6309 (69%) of the 9098 eligible women were
tested. Screening rate
improved progressively from 42% in 2014 to 75% in 2
015. Recto-vaginal GBS
carriage rate was 29.4% (1822/6193). All strains we
re susceptible to penicillin but 11.3% (206/1822) were resistant to clindamycin.
Early-onset GBS rate fell from 0.99/1000 live births (25/25276) in the pre-screening period to 0.33/1000 in the screening period (Rate Ratio=0.33; p=0.08) I
n the subset of mothers actually screened, the rate was 0.16/1000 live birt
hs (1/6309), (Rate Ratio = 0.16; p<0.05).
Conclusions
Our findings confirm that an antenatal screening pr
ogramme for prevention of early onset GBS infection can be implemented in a UK maternity setting and is associated with a fall in infection rates.
Date Issued
2017-04-01
Date Acceptance
2017-02-09
Citation
BMJ Open, 2017, 7 (4)
ISSN
2044-6055
Publisher
BMJ Publishing Group
Journal / Book Title
BMJ Open
Volume
7
Issue
4
Copyright Statement
© 2017 The Authors. Published by the BMJ Publishing Group Limited. This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Subjects
Group B Streptococcus
early onset infection
neonates
screening
Publication Status
Published
Article Number
e014634