Group B streptococcal infection laboratory tests: Difference between revisions
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* Well-appearing infants whose mothers had no [[chorioamnionitis]] and no indication for GBS prophylaxis should be managed according to routine clinical care, and '''no routine diagnostic testing''' is recommended. | * Well-appearing infants whose mothers had no [[chorioamnionitis]] and no indication for GBS prophylaxis should be managed according to routine clinical care, and '''no routine diagnostic testing''' is recommended. | ||
* Well-appearing infants of any gestational age whose mother received adequate intrapartum GBS prophylaxis (≥4 hours of [[penicillin]], [[ampicillin]], or [[cefazolin]] before delivery) should be observed for ≥48 hours, and '''no routine diagnostic testing''' is recommended (class B, level of evidence III). | * Well-appearing infants of any gestational age whose mother received adequate intrapartum GBS prophylaxis (≥4 hours of [[penicillin]], [[ampicillin]], or [[cefazolin]] before delivery) should be observed for ≥48 hours, and '''no routine diagnostic testing''' is recommended (class B, level of evidence III). | ||
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* For well-appearing infants born to mothers who had an indication for GBS prophylaxis but received no or inadequate prophylaxis, if the infant is well-appearing and ≥37 weeks and 0 days' gestational age and the duration of membrane rupture before delivery was <18 hours, then the infant should be observed for ≥48 hours, and '''no routine diagnostic testing''' is recommended (class B, level of evidence III). | * For well-appearing infants born to mothers who had an indication for GBS prophylaxis but received no or inadequate prophylaxis, if the infant is well-appearing and ≥37 weeks and 0 days' gestational age and the duration of membrane rupture before delivery was <18 hours, then the infant should be observed for ≥48 hours, and '''no routine diagnostic testing''' is recommended (class B, level of evidence III). | ||
* If the infant is well-appearing and either <37 weeks and 0 days' gestational age or the duration of membrane rupture before delivery was ≥18 hours, then the infant should undergo a '''limited diagnostic evaluation''' and observation for ≥48 hours (class B, level of evidence III). | * If the infant is well-appearing and either <37 weeks and 0 days' gestational age or the duration of membrane rupture before delivery was ≥18 hours, then the infant should undergo a '''limited diagnostic evaluation''' and observation for ≥48 hours (class B, level of evidence III). The limited diagnostic evaluation should include: | ||
* [[CBC]] including [[white blood cell]] differential and [[platelet count]] | |||
* [[Blood culture]] | |||
* No [[chest radiograph]] | |||
* No [[lumbar puncture]] | |||
==References== | ==References== | ||
Revision as of 14:36, 20 August 2014
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Group B Streptococcal Infection Microchapters |
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Differentiating Group B Streptococcal Infection from other Diseases |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Rim Halaby, M.D. [2]
Overview
Laboratory Tests
Infants with Signs of Sepsis
Any newborn with signs of sepsis should receive a full diagnostic evaluation and receive antibiotic therapy pending the results of the evaluation, regardless of the maternal colonization status (class A, level of evidence II).
The full diagnostic evaluation should include:
- CBC including white blood cell differential and platelet count
- Blood culture (Blood cultures can be sterile in as many as 15%--33% of newborns with meningitis)
- Chest radiograph
- Lumbar puncture
- Culture of the cerebrospinal fluid (CSF)
Infants Born to Women with Chorioamnionitis
Well-appearing newborns whose mothers had suspected chorioamnionitis should undergo a limited diagnostic evaluation and receive antibiotic therapy pending culture results (class A, level of evidence II).
The limited diagnostic evaluation should include:
- CBC including white blood cell differential and platelet count
- Blood culture
- No chest radiograph
- No lumbar puncture
Well-Appearing Infants Exposed to Inadequate Intrapartum Antibiotics
- Well-appearing infants whose mothers had no chorioamnionitis and no indication for GBS prophylaxis should be managed according to routine clinical care, and no routine diagnostic testing is recommended.
- Well-appearing infants of any gestational age whose mother received adequate intrapartum GBS prophylaxis (≥4 hours of penicillin, ampicillin, or cefazolin before delivery) should be observed for ≥48 hours, and no routine diagnostic testing is recommended (class B, level of evidence III).
- For well-appearing infants born to mothers who had an indication for GBS prophylaxis but received no or inadequate prophylaxis, if the infant is well-appearing and ≥37 weeks and 0 days' gestational age and the duration of membrane rupture before delivery was <18 hours, then the infant should be observed for ≥48 hours, and no routine diagnostic testing is recommended (class B, level of evidence III).
- If the infant is well-appearing and either <37 weeks and 0 days' gestational age or the duration of membrane rupture before delivery was ≥18 hours, then the infant should undergo a limited diagnostic evaluation and observation for ≥48 hours (class B, level of evidence III). The limited diagnostic evaluation should include:
- CBC including white blood cell differential and platelet count
- Blood culture
- No chest radiograph
- No lumbar puncture