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Group B Strep Infection

From: Kallie Brown (kallieoshis_98@hotmail.com)
Wed, 06 Mar 2002 19:59:58 -0600

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My name is Kallie Brown and I am a nursing student at the University of North Dakota. I have been researching the effectiveness of protocol typically used for pregnant women with either known or suspected group B streptococcal infection. According to Keenan (1998), there are two common methods typically used for preventing group B streptococcal (GBS) infection. One type is implementing a universal vaginal/rectal culture in the antepartum or peripartum period followed up with antibiotic prophylaxis in positive cultures. The other method is treating with antibiotic prophylaxis based on risk factors alone. Keenan also explored the cost-effectiveness of these two types of prevention and concluded that using risk factors to determine use of antibiotics is much more cost-effective than providing universal cultures. The author was careful to point out that either strategy would be less expensive than treating an unprevented GBS case. In one study conducted by Halliday, Foote, Dryden, and Heard, (2000), the incidence of GBS in the UK is 1 in every 1,000 live births when only risk factors are used to determine the use of antibiotic prophylaxis. The authors concluded that universal vaginal/rectal cultures would prevent more cases of GBS than using risk factors alone, however this would also lead to an increase in the number of women receiving antibiotic prophylaxis. Another study was performed by Baltimore, Huie, Meek, Schuchat, and O’Brien, (2001) to determine if the use of antibiotic prophylaxis in pregnant women would also increase the rate of antibiotic resistance. During their four year study from 1996 to 1999, there was not an increase in the rate of sepsis from a non-GBS species. I am wondering what methods you see being used to prevent GBS and if you have noticed any antibiotic resistance (sepsis from non-GBS species). Thank you, Kallie Brown Nursing Student, University of North Dakota

Baltimore, R. S., Huie, S. M., Meek, J. I., Schuchat, A., & O’Brien, K. L. (2001). Early onset neonatal sepsis in the eral of group B streptococcal prevention. Pediatrics,108, 1094-1098.

Halliday, E., Foote, K., Dryden, M. & Heard, M. (2000). Universal maternal screening for neonatal group B streptococcal disease. The Lancet, 356, 1407-1408.

Keenan, C. (1998). Prevention of neonatal group B streptococcal infection. American Family Physician, 57, 2713-2720.

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