Group B streptococcal infection screening
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [2]; Associate Editor(s)-in-Chief: Rim Halaby, M.D. [3]
Overview
Screening
Indications
CDC's guidelines recommend universal culture-based screening for all pregnant women for vaginal and rectal GBS colonization (class A, level of evidence II) to determine which women should receive intrapartum GBS chemoprophylaxis. CDC recommended that women with unknown GBS colonization status at the time of delivery be managed according to the presence of intrapartum risk factors.
Timing
CDC's guidelines recommend screening for vaginal and rectal GBS colonization at 35-37 weeks' gestation.
Culture- Versus Risk-Based Screening
Early guidelines recommended the use of one of two approaches to identifying women who should receive intrapartum antibiotic prophylaxis: a risk-based approach or a culture-based screening approach.[1] A large population-based study conducted during 1998--1999 demonstrated the superiority of culture-based screening over the risk-based approach to prevention of early-onset GBS disease.[2] The study found that culture-based screening resulted in the identification of a greater proportion of women at risk for transmitting GBS to their newborns.
Risk-Based Method
Providers using the risk-based method identified candidates for intrapartum chemoprophylaxis according to the presence of any of the following intrapartum risk factors:
- Delivery at <37 weeks' gestation
- Intrapartum temperature ≥100.4ºF (≥38.0ºC)
- Rupture of membranes for ≥18 hours
Culture-Based Method
Providers using the culture-based screening method screened all pregnant women between 35 and 37 week's gestation for:
- Vaginal GBS colonization
- Rectal GBS colonization
Specimen Collection and Processing for GBS Screening
References
- ↑ CDC. Prevention of perinatal group B streptococcal disease: a public health perspective. MMWR 1996;45(No. RR-7).[1]
- ↑ Schrag SJ, Zell ER, Lynfield R, Roome A, Arnold KE, Craig AS; et al. (2002). "A population-based comparison of strategies to prevent early-onset group B streptococcal disease in neonates". N Engl J Med. 347 (4): 233–9. doi:10.1056/NEJMoa020205. PMID 12140298.