Materiały źródłowe

• #1 Prevention of Group B Streptococcal Early-Onset Disease in Newborns | ACOG

  https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2020/02/prevention-of-group-b-streptococcal-early-onset-disease-in-newborns

  ABSTRACT: Group B streptococcus (GBS) is the leading cause of newborn infection. The primary risk factor for neonatal GBS early-onset disease (EOD) is maternal colonization of the genitourinary and gastrointestinal tracts. Approximately 50% of women who are colonized with GBS will transmit the bacteria to their newborns. Vertical transmission usually occurs during labor or after rupture of membranes. In the absence of intrapartum antibiotic prophylaxis, 12% of those newborns will develop GBS EOD. […] The key obstetric measures necessary for effective prevention of GBS EOD continue to include universal prenatal screening by vaginalrectal culture, correct specimen collection and processing, appropriate implementation of intrapartum antibiotic prophylaxis, and coordination with pediatric care providers. The American College of Obstetricians and Gynecologists now recommends performing universal GBS screening between 36 0/7 and 37 6/7 weeks of gestation. All women whose vaginalrectal cultures at 36 0/737 6/7 weeks of gestation are positive for GBS should receive appropriate intrapartum antibiotic prophylaxis unless a prelabor cesarean birth is performed in the setting of intact membranes.

• #1 Group B Streptococcus and Pregnancy – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK482443/

  Group B streptococcus, or Streptococcus agalactiae, is a gram-positive bacterium commonly found in the genital and gastrointestinal tracts of humans and less frequently in the upper respiratory tracts of children and adults, which poses significant health risks, particularly to neonates, young infants, pregnant women, and those with certain medical conditions. […] Universal third-trimester screening and intrapartum antibiotic prophylaxis have significantly reduced neonatal group B streptococcus infections, although these measures may have unintended consequences for mothers and infants. […] Effective prevention of neonatal group B streptococcus disease depends on proper screening, timely antibiotic administration, and coordination with pediatric care clinicians. […] Despite CDC recommendations for routine group B streptococcus screening and intrapartum antibiotics, group B streptococcus remains a leading cause of early-onset neonatal sepsis in the United States.

• #1 Prevention of early-onset group B streptococcal disease in neonates – UpToDate

  https://www.uptodate.com/contents/prevention-of-early-onset-group-b-streptococcal-disease-in-neonates

  Prevention of early-onset group B streptococcal disease in neonates […] In the mid-1980s, randomized trials demonstrated that intrapartum intravenous administration of penicillin G or ampicillin to GBS-colonized pregnant people protected their newborns from developing early-onset disease (ie, GBS infection at zero through six days of age) […] Based upon this evidence, in the United States, the Centers for Disease Control and Prevention published updated guidelines for prevention of neonatal GBS disease in 2002 and 2010, and the American College of Obstetricians and Gynecologists (ACOG) took over this role in 2019. The key intervention in these guidelines is intrapartum intravenous antibiotic prophylaxis of pregnant patients whose infants are at risk of developing early-onset GBS infection because the maternal GBS test was positive in the weeks before giving birth or because of maternal characteristics that increase the risk of early-onset GBS disease in their offspring. […] This topic will discuss our approach to prevention of early-onset GBS. This approach is generally similar to the 2019 ACOG guidelines for prevention of early-onset GBS disease.

• #1 Updated Guidance on GBS Screening and Prophylaxis – The ObG Project

  https://www.obgproject.com/2023/02/06/cdc-algorithm-intrapartum-antibiotic-prophylaxis-gbs/

  Group B streptococcal (GBS) disease remains a leading cause of early-onset neonatal sepsis in the US. The ACOG committee opinion has been endorsed by the AAP, ACNM, AWHONN and SMFM. Furthermore, CDC states that the ACOG committee opinion supersedes the 2010 CDC recommendations. […] Universal screening with a window of 36w0d – 37w6d […] Penicillin still remains agent of choice for intrapartum prophylaxis and penicillin allergy testing. […] Intrapartum antibiotic prophylaxis is recommended for women who delivered a previous infant with GBS disease, with GBS bacteriuria in the current pregnancy, with a GBS-positive screening result in the current pregnancy, and with unknown GBS status. […] Note: (1) Penicillin remains the preferred agent with ampicillin an acceptable alternative; (2) Clinicians do not need to test women who had a previous baby who developed GBS disease – These women should receive antibiotics.

• #1 Group B Streptococcus | Diagnostic Laboratory Services, Inc.

  https://dlslab.com/physicians/group-b-streptococcus/

  In the second preventative strategy, where screening cultures are not done, intrapartum chemoprophylaxis will be given if one or more of the following conditions occur: membrane rupture lasting = 18 hours, intrapartum temperature =38 deg. C, and/or gestation. […] Optimal identification of GBS carriers is dependent not only on the timing of the culture but on the appropriate sites of collection. […] The laboratory performing the culture should use a broth selective for GBS. […] For intrapartum hemoprophylaxis, intravenous (IV) penicillin G (5 million units initially and then 2.5 million units every 4 hours) should be administered until delivery.

• #1 Group B Streptococcus (GBS) Infections Guidelines: GBS Prophylaxis in Preterm Labor

  https://emedicine.medscape.com/article/229091-guidelines

  For prevention of early-onset GBS infection, penicillin G remains the agent of choice. For women with penicillin allergy in whom the risk for anaphylaxis is considered to be low and/or in whom the severity of a reaction is uncertain, first-generation cephalosporins can be used. For women with penicillin allergy in whom the risk for anaphylaxis is high, penicillin allergy testing should be performed, if available, and cultures should include testing for susceptibility to clindamycin. Intravenous vancomycin remains the agent of choice for patients with high-risk penicillin allergy and also for those with GBS isolates not susceptible to clindamycin. […] The following scenarios are indications for intrapartum prophylaxis: Maternal history of delivery of a neonate with invasive GBS disease, Positive GBS cultures obtained at 36 0/7 weeks of gestation or later during pregnancy, GBS bacteriuria during any trimester of current pregnancy, Unknown GBS status at onset of labor and any of the following: Delivery before 37 0/7 weeks of gestation, Amniotic rupture of membranes 18 hours or more before delivery, Maternal fever (38 C) during labor, Positive result of nucleic amplification testing for GBS, Negative result of nucleic amplification testing for GBS but patient has 1 of the first 3 risk factors listed. […] Intrapartum antibiotics are not required for GBS carriers who are having a planned cesarean delivery with intact membranes and no labor.

• #1 CDC Updates Guidelines for the Prevention of Perinatal GBS Disease | AAFP

  https://www.aafp.org/pubs/afp/issues/2011/0501/p1106.html

  The Centers for Disease Control and Prevention (CDC) published guidelines for the prevention of perinatal group B streptococcus (GBS) disease in 1996; the guidelines were updated in 2002 and again in 2010. The most recent guidelines elaborate on laboratory methods and thresholds for GBS identification, discuss a change to the recommended dose of penicillin G for antibiotic prophylaxis, and provide updates on prophylactic regimens for patients who are allergic to penicillin. […] Based on the updated CDC guidelines, women who have previously given birth to an infant with invasive GBS disease should receive intrapartum antibiotic prophylaxis. Universal culture-based screening is recommended for all other pregnant women to identify candidates for intrapartum prophylaxis. […] Pregnant women who test positive for GBS colonization should be given intrapartum antibiotic prophylaxis at the time of labor or rupture of membranes, with the exception of patients undergoing cesarean delivery before onset of labor with intact amniotic membranes (in whom intrapartum antibiotic prophylaxis is not recommended, regardless of GBS colonization status or gestational age).

• #1 Prevention of Group B Streptococcal Early-Onset Disease in Newborns | ACOG

  https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2020/02/prevention-of-group-b-streptococcal-early-onset-disease-in-newborns

  If the prenatal GBS culture result is unknown when labor starts, intrapartum antibiotic prophylaxis is indicated for women who have risk factors for GBS EOD. […] If a woman presents in labor at term with unknown GBS colonization status and does not have risk factors that are an indication for intrapartum antibiotic prophylaxis but reports a known history of GBS colonization in a previous pregnancy, the risk of GBS EOD in the neonate is likely to be increased. […] Intravenous penicillin remains the agent of choice for intrapartum prophylaxis, with intravenous ampicillin as an acceptable alternative. […] For women who are at high risk of anaphylaxis after exposure to penicillin, the laboratory requisitions for ordering antepartum GBS screening cultures (whether on paper or online in electronic medical records) should indicate clearly the presence of penicillin allergy.

• #1

  https://journals.lww.com/greenjournal/fulltext/2020/02000/prevention_of_group_b_streptococcal_early_onset.43.aspx

  If the prenatal GBS culture result is unknown when labor starts, intrapartum antibiotic prophylaxis is indicated for women who have risk factors for GBS EOD. […] If a woman presents in labor at term with unknown GBS colonization status and does not have risk factors that are an indication for intrapartum antibiotic prophylaxis but reports a known history of GBS colonization in a previous pregnancy, the risk of GBS EOD in the neonate is likely to be increased. […] Intravenous penicillin remains the agent of choice for intrapartum prophylaxis, with intravenous ampicillin as an acceptable alternative. […] For women who are at high risk of anaphylaxis after exposure to penicillin, the laboratory requisitions for ordering antepartum GBS screening cultures (whether on paper or online in electronic medical records) should indicate clearly the presence of penicillin allergy.

• #1 Prevention of Group B Streptococcal Early-Onset Disease in Newborns | ACOG

  https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2020/02/prevention-of-group-b-streptococcal-early-onset-disease-in-newborns

  Targeted intravenous intrapartum antibiotic prophylaxis has demonstrated efficacy for prevention of GBS early-onset disease (EOD) in neonates born to women with positive antepartum GBS cultures and women who have other risk factors for intrapartum GBS colonization. […] Regardless of planned mode of birth, all pregnant women should undergo antepartum screening for GBS at 36 0/737 6/7 weeks of gestation, unless intrapartum antibiotic prophylaxis for GBS is indicated because of GBS bacteriuria during the pregnancy or because of a history of a previous GBS-infected newborn. […] All women whose vaginalrectal cultures at 36 0/737 6/7 weeks of gestation are positive for GBS should receive appropriate intrapartum antibiotic prophylaxis unless a prelabor cesarean birth is performed in the setting of intact membranes.

• #1

  https://journals.lww.com/greenjournal/fulltext/2020/02000/prevention_of_group_b_streptococcal_early_onset.43.aspx

  Targeted intravenous intrapartum antibiotic prophylaxis has demonstrated efficacy for prevention of GBS early-onset disease (EOD) in neonates born to women with positive antepartum GBS cultures and women who have other risk factors for intrapartum GBS colonization. Neither antepartum nor intrapartum oral or intramuscular regimens have been shown to be comparably effective in reducing GBS EOD. […] Regardless of planned mode of birth, all pregnant women should undergo antepartum screening for GBS at 36 0/737 6/7 weeks of gestation, unless intrapartum antibiotic prophylaxis for GBS is indicated because of GBS bacteriuria during the pregnancy or because of a history of a previous GBS-infected newborn. […] All women whose vaginalrectal cultures at 36 0/737 6/7 weeks of gestation are positive for GBS should receive appropriate intrapartum antibiotic prophylaxis unless a prelabor cesarean birth is performed in the setting of intact membranes.

• #1 New group B strep guidelines clarify management of key groups | MDedge

  https://community.the-hospitalist.org/content/new-group-b-strep-guidelines-clarify-management-key-groups

  Penicillin remains the agent of choice for intrapartum prophylaxis, but ampicillin is an acceptable alternative. […] The CDC no longer considers erythromycin to be an acceptable alternative for intrapartum GBS prophylaxis for penicillin-allergic women at high risk of anaphylaxis. […] In the absence of a licensed GBS vaccine, universal screening and intrapartum antibiotic prophylaxis continue to be the cornerstones of early-onset GBS disease prevention.

• #1 New group B strep guidelines clarify management of key groups | MDedge

  https://community.the-hospitalist.org/content/new-group-b-strep-guidelines-clarify-management-key-groups

  new recommended dosage of penicillin G for prophylaxis […] updated regimens for prophylaxis among women who are allergic to penicillin. […] In its report, the CDC reiterated the indications and nonindications for intrapartum prophylaxis. Among the clarifications: […] Women who have GBS isolated from the urine at any time during pregnancy should undergo intrapartum prophylaxis. They do not need third-trimester screening for GBS. […] Women who had a previous infant with invasive GBS disease should also undergo intrapartum prophylaxis, with no need for third-trimester screening […] All other pregnant women should undergo screening at 35 to 37 weeks gestation. If results are positive, intrapartum prophylaxis is indicated. […] The CDC now recommends a dosage of 5 million units of IV penicillin G for GBS prophylaxis, followed by 2.5 to 3.0 million units IV every 4 hours.

• #1 Prevention of Group B Streptococcal Early-Onset Disease in Newborns | ACOG

  https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2020/02/prevention-of-group-b-streptococcal-early-onset-disease-in-newborns

  Intravenous vancomycin remains the only pharmacokinetically and microbiologically validated option for intrapartum antibiotic prophylaxis in women who report a high-risk penicillin allergy and whose GBS isolate is not susceptible to clindamycin. […] Obstetric interventions, when necessary, should not be delayed solely to provide 4 hours of antibiotic administration before birth.

• #1

  https://journals.lww.com/greenjournal/fulltext/2020/02000/prevention_of_group_b_streptococcal_early_onset.43.aspx

  Intravenous vancomycin remains the only pharmacokinetically and microbiologically validated option for intrapartum antibiotic prophylaxis in women who report a high-risk penicillin allergy and whose GBS isolate is not susceptible to clindamycin. […] Obstetric interventions, when necessary, should not be delayed solely to provide 4 hours of antibiotic administration before birth.

• #1 Group B Streptococcal Prophylaxis (570) | Right Decisions

  https://rightdecisions.scot.nhs.uk/maternity-gynaecology-guidelines/maternity/infections/group-b-streptococcal-prophylaxis-570/

  Prophylaxis is more effective if the first dose is given at least 4 hours prior to delivery and continued at the correct intervals. Antibiotics should be started as soon as possible after the onset of labour and continued until delivery. […] Women who are receiving prophylactic antibiotics for GBS in labour who require a caesarean section will still require routine co-amoxiclav or clindamycin cover. […] Women with rupture of membranes at term (37+0 weeks gestation) who are known GBS carriers should be offered immediate IAP and induction of labour as soon as reasonably possible. […] GBS prophylaxis is offered by maternity staff to the mother and this must be adequately explained.

• #1 Group B Strep — CREOGS Over Coffee

  https://creogsovercoffee.com/notes/2020/2/2/group-b-strep

  Intrapartum Antibiotic Treatment […] The gold standard for the treatment of GBS colonization intrapartum to reduce risk to neonates for early-onset disease is penicillin G. […] For this reason, identification and history of penicillin allergy is super important to flush out in prenatal care! […] When PCN allergy testing has not been performed, the allergy should be classified as low versus high risk, based on the symptoms just described. […] All antibiotics used for GBS prophylaxis are time-dependent with respect to their ability to lower microbial load. […] Studies done with PCN or ampicillin prophylaxis demonstrate that 4 or more hours of prophylaxis is preferable, though 2 hours has been shown to reduce GBS count and decrease neonatal sepsis.

• #1 Patient education: Group B streptococcus and pregnancy (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/group-b-streptococcus-and-pregnancy-beyond-the-basics/print

  If you go into preterm labor — If you go into preterm (premature) labor before you’ve been tested to find out if you carry GBS, a swab culture or NAAT will be done when you are admitted to the hospital (see 'Routine screening for GBS’ above). Then you will be treated with an IV antibiotic until your baby is born or the labor is stopped by your health care provider or labor stops on its own. […] If you have a planned cesarean birth („C-section”), you will not need IV antibiotics because the risk of passing GBS on to the newborn is much lower than with a vaginal birth. However, even if you plan ahead to have a C-section, you should still be tested for GBS during pregnancy. […] If you have an allergy to penicillin, be sure your health care providers are aware of this allergy early in your pregnancy.

• #1 Prevention of Perinatal Group B Streptococcal Disease: Updated CDC Guideline | AAFP

  https://www.aafp.org/pubs/afp/issues/2012/0701/p59.html

  Group B streptococcus is the leading cause of early-onset neonatal sepsis in the United States. Universal screening is recommended for pregnant women at 35 to 37 weeks gestation. The Centers for Disease Control and Prevention recently updated its guideline for the prevention of early-onset neonatal group B streptococcal disease. […] The new guideline presents separate algorithms for management of preterm labor and preterm premature rupture of membranes, rather than a single algorithm for both conditions. […] The guideline provides new recommendations about antibiotic regimens for women with penicillin allergy. Cefazolin is recommended for women with minor allergies. […] For those at serious risk of anaphylaxis, clindamycin is recommended if the organism is susceptible, and vancomycin is recommended if there is clindamycin resistance or if susceptibility is unknown.

• #1 Prevention of Perinatal Group B Streptococcal Disease: Updated CDC Guideline | AAFP

  https://www.aafp.org/pubs/afp/issues/2012/0701/p59.html

  The new algorithm for secondary prevention of early-onset group B streptococcal disease in newborns should be applied to all infants, not only those at high risk of infection. […] The previous CDC guideline recommended that any amount of group B streptococcal bacteriuria be considered a positive culture. […] The new guideline reflects findings that only concentrations exceeding 104 colony-forming units per mL are associated with early-onset neonatal disease. […] The new guideline offers separate, more detailed algorithms for each of these situations, including recommendations for antibiotic regimens to prolong latency while also providing adequate coverage against GBS. […] Penicillin is the recommended antibiotic for intrapartum chemoprophylaxis of group B streptococcal disease; ampicillin is an acceptable alternative.

• #1

  https://journals.lww.com/mfm/fulltext/2020/04000/prevention_of_perinatal_group_b_streptococcus.8.aspx

  The recommended time for universal culture-based screening for GBS is ranges from 36 0/7 to 37 6/7 weeks of gestation. […] Culture-based testing remains the standard for maternal antenatal GBS screening. […] Penicillin remains the main agent of choice for IAP, and ampicillin is an acceptable alternative. The definition of adequate IAP has been clarified to be at least 4 hours of penicillin, ampicillin, or cefazolin. […] The regimens and algorithms for antenatal GBS screening and IAP are shown in Figure 4. […] The recommended management strategy for newborn infants of mothers with vaginal and/or rectal GBS is as follows: (1) all newborn infants with signs of sepsis should undergo a full diagnostic evaluation and receive empirical antimicrobial therapy; (2) all well-appearing newborn infants born to women who are diagnosed with chorioamnionitis by their obstetrical providers should undergo a limited diagnostic evaluation and receive empirical antimicrobial therapy; (3) for all women who receive adequate IAP defined as penicillin, ampicillin, or cefazolin for 4 or more hours before delivery, their newborn infants require only routine care and observation in the hospital for 48 hours. […] Maternal anaphylaxis associated with GBS IAP may occur though it is rare. The morbidity associated with anaphylaxis is balanced by the reduction in adverse outcomes associated with GBS colonization.

• #1 Group B Streptococcus (GBS) in pregnancy and newborn babies | RCOG

  https://www.rcog.org.uk/for-the-public/browse-our-patient-information/group-b-streptococcus-gbs-in-pregnancy-and-newborn-babies/

  If your baby is felt to be at higher risk of GBS infection and you did not get antibiotics through a drip at least 4 hours before giving birth then your baby will be monitored closely for signs of infection for at least 12 hours. […] Babies with signs of GBS infection or babies who are suspected to have the infection should be treated with antibiotics as soon as possible.

• #1 Strategies to Prevent Early and Late-Onset Group B Streptococcal Infection via Interventions in Pregnancy

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9959229/

  IAP has substantially reduced the incidence of EOD. […] However, IAP has not fully eliminated neonatal GBS disease, because it cannot prevent the risk of ascending infection during pregnancy and has no impact on horizontal transmission routes and thus LOD. […] Hence, improved preventive measures are urgently needed to fully address the burden of GBS disease for pregnant people and infants. […] One approach to restrict or eliminate GBS colonization in pregnant women is by using oral probiotics; however, the reported efficacy of probiotics in GBS colonization prevention is uncertain. […] Ultimately, to significantly reduce the global GBS burden of disease, the most effective and attractive strategy is likely to be immunization during pregnancy. […] The results of these studies have led to the development of GBS vaccines and clinical studies in different populations.

• #1 Natural Treatment For Group B Strep – Dr. Green Mom

  https://drgreenmom.com/natural-treatment-for-gbs-in-pregnancy/

  Probiotics are safe to use in pregnancy and are my favorite natural remedy for GBS prevention. […] Several different strains of probiotics have been studied for GBS prevention and treatment. While almost all probiotics will offer some benefit, probiotics with the strains listed below will likely be the most effective at preventing GBS. […] Using vaginal probiotic suppositories has the advantage of delivering probiotics directly to the area where they are needed. Probiotic suppositories are less well researched for GBS prevention, but they have a long history of use by many mothers and midwives. […] Speak with an experienced practitioner before using herbal vaginal suppositories during pregnancy. […] Zinc may help kill group B strep. Pregnant women can safely take up to 40mg of zinc per day. If a patient tests positive for GBS, I often have her increase her zinc intake through food or supplementation. […] Preventing and treating group B strep colonization may lead to better pregnancy outcomes. There are many natural options for reducing GBS, including herbs, probiotics, nutrients, and lifestyle changes.

• #1 Strategies to Prevent Early and Late-Onset Group B Streptococcal Infection via Interventions in Pregnancy

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9959229/

  Currently, the most promising vaccine candidates are either capsular polysaccharide (CPS) including polysaccharide-based vaccines and polysaccharide conjugate vaccines, or protein-based subunit vaccines. […] In summary, no GBS vaccine is approved yet but trials evaluating immunization of pregnant women against GBS hold promising results for the reduction of neonatal GBS disease.

• #1 Clinical Characteristics and Treatment Strategies for Group B Streptococcus (GBS) Infection in Pediatrics: A Systematic Review

  https://www.mdpi.com/1648-9144/59/7/1279

  Group B streptococcus (GBS) is the leading cause of infections in neonates with high fatality rates. […] The studies suggest that preventive measures, risk-based intrapartum antibiotic prophylaxis, and maternal vaccination can significantly reduce the burden of GBS disease, but late-onset GBS disease remains a concern, and more strategies are required to decrease its rate. […] A conjugate vaccine with a serotype (Ia, Ib, II, III, and V) has been proven effective in the prevention of GBS in neonates. […] Moreover, penicillin is an important core antibiotic for treating early onset GBS (EOD). […] IAP (intrapartum antibiotic prophylaxis) according to guidelines, antenatal screening, and the development of a conjugate vaccine may be effective and could lower the incidence of the disease.

• #1 Group B strep disease – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/group-b-strep/symptoms-causes/syc-20351729

  Medicine can prevent group B bacteria from spreading to your baby during labor or delivery. An antibiotic through a needle in a vein, also called an IV, is given to you when labor begins. The antibiotic is usually penicillin or a related medicine. […] If you’re allergic to penicillin or related medicines, you might receive another antibiotic such as clindamycin or vancomycin instead. But it’s not clear how well these other antibiotics work. […] Taking antibiotics by mouth ahead of time won’t help lower the risk of passing the bacteria to your baby. That’s because the bacteria can return before labor begins. […] Antibiotic treatment during labor also is recommended if you: Have a urinary tract infection. Delivered a previous baby with group B strep disease. Get a fever during labor. Haven’t delivered your baby within 18 hours of your water breaking. Go into labor before 37 weeks and haven’t been tested for group B strep. […] Although it’s not available yet, researchers are working on a group B strep vaccine. It could help prevent group B strep infections in the future.

• #1 Group B Strep Infection in Pregnancy and Newborns

  https://www.medicinenet.com/group_b_strep/article.htm

  Although there is currently no licensed vaccine available for the prevention of GBS infection, there is research underway to try to develop one for use in the future. Further information about GBS can be found at the U.S. Centers for Disease Control and Prevention website (https://www.cdc.gov/groupbstrep/index.html).

• #1

  https://www.cdc.gov/mmwr/preview/mmwrhtml/00043277.htm

  These guidelines are intended for the following groups: a) providers of prenatal, obstetric, and pediatric care; b) supporting microbiology laboratories, hospital administrators, and managed-care organizations; c) childbirth educators; d) public health authorities; e) expectant parents; and f) advocacy groups for expectant parents. […] Many perinatal GBS infections can be prevented through intrapartum antimicrobial prophylaxis. GBS disease prevention programs require coordinated efforts among numerous specialties (e.g., providers of prenatal, obstetric, and pediatric care; supporting microbiology laboratories; managed-care organizations; quality assurance personnel; childbirth educators; and public health authorities). […] Intrapartum chemoprophylaxis (i.e., administration of antimicrobial agents after onset of labor or membrane rupture but before delivery) is the most likely method of preventing both early-onset disease and maternal illness resulting from GBS; several antimicrobial regimens have been used for intrapartum chemoprophylaxis.

• #1 Evidence on Group B Strep in Pregnancy

  https://evidencebasedbirth.com/groupbstrep/

  If the birthing person with GBS is treated with antibiotics during labor, the risk of their infant developing early GBS disease drops by 80%. So, for example, the risk could drop from 1% down to 0.2%. […] The universal screening approach worked better than the other risk factor approach at preventing early GBS disease. Overall, there were 0.5 infants born with GBS per every 1,000 births. […] The findings from this landmark study convinced the CDC to revise their guidelines in 2002 and only recommend the universal screening approach. […] In summary, although these studies had limitations (not uncommon for research published before 1996), there is also some valid information that we can use. […] Although it would be best if we had modern, larger, randomized, controlled trials on antibiotics for Group B Strep, such trials will not be available given that antibiotics are already in routine use, and it could be considered unethical to withhold antibiotics.

• #1 Evidence on Group B Strep in Pregnancy

  https://evidencebasedbirth.com/groupbstrep/

  In 2019, when researchers published another analysis of early GBS disease in the U.S. and the effects of universal screening as prevention, they found that GBS disease continued to drop further (to 0.23 per 1,000 live births). […] The 2019 ACOG recommendations (reaffirmed in 2022 and endorsed by the AAP) include: All pregnant people should be tested for GBS between 36 weeks 0 days and 37 weeks 6 days. Everyone who is positive for GBS should have appropriate IV antibiotics during birth unless they are giving birth by pre-labor Cesarean and the membranes have not yet ruptured.

• #1 Group B Streptococcus | Children’s Hospital of Philadelphia

  https://www.chop.edu/conditions-diseases/group-b-streptococcus

  If the mother has a positive GBS culture during pregnancy, the CDC and the American College of Obstetricians and Gynecologists recommend treatment with intravenous (IV) antibiotics during labor to reduce the risk of transmission of the infection to the baby. […] It is important to understand that, in spite of testing and treatment, some babies still develop GBS disease. Research is ongoing to develop vaccines to prevent GBS disease. In the future, women who are vaccinated against GBS may make antibodies that cross the placenta and protect the baby during birth and early infancy.

• #1 Family Health Service – Prevention of Neonatal Group B Streptococcus Infection

  https://www.fhs.gov.hk/english/health_info/woman/478.html

  Group B Streptococcus (GBS) is a type of bacteria which normally lives in the intestine, urinary and reproductive tracts of men and women. […] The most serious health effect of GBS is that a woman colonised with GBS late in her pregnancy can pass it to her baby. […] If you are test positive for GBS, we recommend giving you intravenous injection of antibiotics during delivery which can greatly reduce the chance of your baby becoming sick. […] The most effective way to prevent baby’s infection is to give the antibiotic during labour. […] Under these conditions, we recommend injection of antibiotic during labour and screening is not necessary. […] In case your GBS status is unknown and if any of the following condition is present, we recommend you to have antibiotic during labour. […] Although antibiotic treatment during labour helps to prevent early-onset GBS infection, it is not 100% and does not always prevent late-onset GBS infection.

• #1 Group B Streptococcus and Pregnancy – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK482443/

  GBS colonization in pregnancy is primarily treated with IAP to decrease the transmission of GBS and the incidence of neonatal sepsis by reducing the maternal GBS burden within the genitourinary tract and eliminating GBS bacteria in the fetus. […] However, IAP guidelines are not consistently implemented; therefore, GBS remains a leading cause of early-onset neonatal sepsis in the United States. […] Indications for intrapartum GBS prophylaxis include: GBS colonization identified by antenatal culture, GBS bacteriuria detected during pregnancy, history of a previous infant with GBS disease, unknown GBS status and preterm labor or preterm premature rupture of membranes (37 0/7 weeks). […] ACOG recommends penicillin as the first-line antibiotic for GBS prophylaxis due to its narrow antimicrobial activity, which decreases the risk of resulting antibiotic resistance.

• #2

  https://journals.lww.com/greenjournal/fulltext/2020/02000/prevention_of_group_b_streptococcal_early_onset.43.aspx

  Group B streptococcus (GBS) is the leading cause of newborn infection. The primary risk factor for neonatal GBS early-onset disease (EOD) is maternal colonization of the genitourinary and gastrointestinal tracts. Approximately 50% of women who are colonized with GBS will transmit the bacteria to their newborns. Vertical transmission usually occurs during labor or after rupture of membranes. In the absence of intrapartum antibiotic prophylaxis, 12% of those newborns will develop GBS EOD. Other risk factors include gestational age of less than 37 weeks, very low birth weight, prolonged rupture of membranes, intraamniotic infection, young maternal age, and maternal black race. The key obstetric measures necessary for effective prevention of GBS EOD continue to include universal prenatal screening by vaginalrectal culture, correct specimen collection and processing, appropriate implementation of intrapartum antibiotic prophylaxis, and coordination with pediatric care providers. The American College of Obstetricians and Gynecologists now recommends performing universal GBS screening between 36 0/7 and 37 6/7 weeks of gestation. All women whose vaginalrectal cultures at 36 0/737 6/7 weeks of gestation are positive for GBS should receive appropriate intrapartum antibiotic prophylaxis unless a prelabor cesarean birth is performed in the setting of intact membranes.

• #2 Group B Streptococcus and Pregnancy – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK482443/

  Therefore, new therapeutics to prevent group B streptococcus colonization at delivery are still being investigated. […] The American College of Obstetricians and Gynecologists (ACOG) recommends universal GBS screening at 36 to 37 6/7 weeks of gestation, with positive cases receiving appropriate intrapartum antibiotics. […] Effective prevention of neonatal GBS disease depends on proper screening, timely antibiotic administration, and coordination with pediatric care clinicians. […] Despite CDC recommendations for routine GBS screening and intrapartum antibiotics, GBS remains a leading cause of early-onset neonatal sepsis in the United States. […] Therefore, evolving therapeutics to prevent GBS colonization at delivery are still being investigated, including probiotic interventions and maternal vaccines.

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