Changes in early-onset group B beta hemolytic streptococcus disease with changing recommendations for prophylaxis

Abstract

Objective: To determine the incidence of early-onset group B beta hemolytic streptococcal (EOGBS) infection and the association between changes in the incidence and intrapartum antibiotic prophylaxis (IAP). Study Design: A retrospective population survey of infants with GBS < 7 days of age with a nested case-control study of non-GBS infants over the same time perioid, January 1985 to December 1998. The incidence of GBS and maternal antibiotic treatment during labor was analyzed as function of time period: prior to publication of guidelines for prevention of EOGBS (1985 - 1992), following AAP/ACOG guidelines (1993 - 1995), and following CDC consensus guidelines (1996 - 1998). Result: Fifty-six cases of EOGBS infection occurred among 53, 088 live births. The incidence declined from 1.5/1000 before any guidelines to 0.67/1000 after AAP/ACOG guidelines (p=0.004), and continued to decline after the CDC consensus statement (0.28/1000) (p=0.38). IAP remained stable (33% of at risk mother) until after introduction of the CDC consensus guidelines (59%, p=0.02) Conclusion: IAP did not fully explain the decline in EOGBS incidence in our center.