The good news is there is 80% less early-onset GBS disease
than there was before the culture screening recommendations came out in 1996, and that's real progress, she said, adding that there is room for improvement--particularly in late-onset disease, which hasn't changed much.
Increased use of intrapattum antibiotics to prevent perinatal group B streptococcal (GBS) disease during the 1990s led to substantial declines in the incidence of GBS disease
in newborns (i).
In multivariate analysis, the risk for early-onset GBS disease
in the screening cohort was less than half that seen with the risk-based method (relative risk 0.46), she reported.
Here we report on the epidemiology of EO and LO GBS disease
in Minnesota over 11 years, the recent emergence of invasive disease in infants with serotype IV GBS, and an increase in disease caused by this serotype in 2010 compared with our previous findings (15).
The overall incidence of invasive GBS disease
among adults and children in 2005 was 12.8 per 100,000 population in blacks, 6.5 per 100,000 in whites, and 5.1 per 100,000 in all other races combined.
In 1996, consensus guidelines for use of intrapartum antibiotic prophylaxis (IAP) to prevent perinatal GBS disease
recommended either of two methods for identifying candidates for chemoprophylaxis: 1) late prenatal culture-based screening for GBS colonization or 2) monitoring of women intrapartum for particular risk factors associated with early-onset GBS disease
Carriage of GBS is a prerequisite for the development of early-onset neonatal GBS disease
(9) and is a convenient endpoint for a cross-sectional study to assess the interaction of GBS and HIV.
Late-onset GBS disease
, defined as that occurring in infants aged 7-89 days, did not change during 1996-2004, the period for which data were analyzed from the CDC's Active Bacterial Core surveillance (ABCs) system.
Regardless of which strategy you choose, all women with GBS bacteriuria (symptomatic or not) during pregnancy and all women who have had a previous infant with GBS disease
are candidates for intrapartum antibiotics.
From 1994 to 1997, the proportion of hospitals with formal intrapartum GBS prevention policies increased from 39% to 59% [5,6]; hospitals that implemented policies reported less GBS disease
among neonates .
Invasive GBS disease
in children beyond infancy is uncommon, occurring mainly as bacteremia without a focus; meningitis caused by GBS is rarely reported (2).
"In addition, this study highlights that pending the introduction of a CBS vaccine, more effective prevention of GBS disease
will require more rapid, more sensitive techniques to screen for GBS colonization and GBS antibiotic resistance," Dr.