Preventing early-onset group B streptococcal sepsis: clinical risk factor-based screening or culture-based screening?

Abstract

INTRODUCTION Two strategies are available for prevention of early-onset group B streptococcal (GBS) sepsis – clinical risk factor-based screening and routine culture-based screening of pregnant women for GBS colonisation. In our hospital, we switched from the former to the latter approach in 2014. METHODS We compared the incidence of early-onset GBS sepsis during 2001–2015 between infants born to pregnant women who were screened for GBS colonisation and those born to women who were not screened. RESULTS Among 41,143 live births, there were nine cases of early-onset GBS sepsis. All infants with GBS sepsis were born to pregnant women who were not screened for GBS colonisation. The incidence of early-onset GBS sepsis among infants of women who were not screened was 0.41 per 1,000 live births (95% confidence interval [CI] 0.19–0.77) when compared to infants of women who were screened, for whom the sepsis incidence was zero per 1,000 live births (95% CI 0–0.19; p = 0.005). CONCLUSION Our data suggests that routine culture-based screening of pregnant women for GBS colonisation is a better preventive strategy for early-onset GBS sepsis in neonates when compared to clinical risk factor-based screening.