Missed opportunities for preventing group B streptococcus infection
- 1Division of Child Health, St George’s, University of London, London, UK
- 2Neonatal Service, Royal Victoria Infirmary, Newcastle upon Tyne, UK
- 3Neonatal Unit, Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
- 4Evelina Children’s Hospital, London, UK
- 5Heart of England NHS Trust, Birmingham, UK
- Correspondence to Stefania Vergnano, Division of Child Health, St George’s, University of London, Cranmer Terrace, London SW17 0RE, UK; stev{at}doctors.org.uk
- Accepted 30 April 2009
- Published Online First 12 May 2009
Abstract
Background: Group B streptococcus (GBS) is the most common cause of early onset (EO) neonatal infection in the UK. National guidelines for its prevention were introduced in 2003. We assessed the opportunities for prevention amongst cases of EO GBS using the electronic Neonatal Infection Surveillance Network (NeonIN).
Methods: Culture proven EO GBS cases occurring between 2004 and 2007 were identified prospectively in eight neonatal units participating in NeonIN. Data concerning risk factors, intrapartum antibiotic (IAP) use and infant outcome were collected retrospectively.
Results: There were 48 cases of GBS over the 4 years (0.52/1000 live-births); 22 male, median gestation 38 weeks. The most common clinical presentation was sepsis and the GBS-attributable mortality was 6%. Risk factors were present in 67% (32) and adequate IAP was given to six of these mothers (19%). If all women with risk factors received prophylaxis, 23 cases (48%) may have been prevented.
Conclusions: Better GBS prevention strategies are required in the UK.
Footnotes
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Competing interests None.
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Provenance and Peer review Not commissioned; externally peer reviewed.
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Ethics approval NeonIN received multi-centre research ethics committee approval from the London-Surrey Borders Research Ethic Committee 05/Q0806/34 in 2005.
