Hostname: page-component-cd9895bd7-gxg78 Total loading time: 0 Render date: 2025-01-03T22:41:47.709Z Has data issue: false hasContentIssue false
  • English
  • Français

Strategies for Preventing Neonatal Group B Streptococcal Disease

Published online by Cambridge University Press:  02 January 2015

Donald A. Goldmann
Donald A. Goldmann*
Affiliation:
Infection Control Program and Division of Infectious Diseases, Children's Hospital, and the Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
*
Division of infectious Diseases, Children's Hospital, 300 Longwood Avenue, Boston, MA 02115
Get access Rights & Permissions [Opens in a new window]

Extract

Despite increased awareness and the availability of potent chemotherapeutic agents, the Group B streptococcus remains the leading cause of life-threatening bacterial infections in the neonatal period. The majority of infections occur in the first few days of life. These so-called “early-onset” infections are often fulminant and are associated with a very high case fatality rate, ranging from more than 20% in recent reports to as high as 80% in older series. “Late-onset” disease occurs, by definition, after the first week of life. It usually presents with meningitis, although a wide spectrum of infections has been reported, including cellulitis, adenitis, septic arthritis, and osteomyelitis. Late-onset disease is usually less serious than early-onset disease, although deaths do occur and major sequelae are not rare. Accordingly, attempts to prevent group B streptococcal infections have concentrated on the more common and frequently lethal early-onset disease. Strategies that have been considered to date include antibiotic- and immuno-prophylaxis. In the preceding article, Easmon advocates an additional approach; topical use of the antiseptic Chlorhexidine gluconate in the vagina during labor.

Type
Research Article
Information
Infection Control & Hospital Epidemiology , Volume 7 , supplement S2: Proceedings of the Second ICI/Stuart Workshop , February 1986 , pp. 137 - 143
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1986

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Boyer, KM, Gadzala, CA, Bind, LI, et al: Selective intrapartum chemoprophy-laxis of neonatal group B streptococcal early-onset disease. I. Epidemiologic rationale. J Infect Dis 1983; 148:795–801.CrossRefGoogle Scholar
2.Pyati, SP, Pildes, RS, Ramamurthy, RS, et al: Decreasing mortality in neonates with early-onset group B streptococcal infection: Reality or artifact? J Pediatr 1981; 98:625–627.CrossRefGoogle ScholarPubMed
3.Baker, CJ, Edwards, MS: Croup B streptococcal infections, in Remington, JS, Klein, JO: Infectious Diseases of the Fetus and Newborn Infant. Philadelphia, WB Saunders, 1983; pp 820–881.Google Scholar
4.Easmon, CSF: The irreducible minimum: Group B streptococcus. Infect Control 1985; 7(suppl): 135–137.Google Scholar
5.Pass, MA, Gray, BM, Khare, S, et al: Prospective studies of group B streptococcal infections in infants. J Pediatr 1979: 95:437–443.Google Scholar
6.Anthony, BF, Okada, DM. Hobel, CJ: Epidemiology of group B streptococcus: Longitudinal observations during pregnancy. J Infect Dis 1978; 137:524–530.Google Scholar
7.Ancona, RJ, Ferrieri, P, William, PP: Maternal factors thai enhance the acquisition of group B streptococci by newborn infants. J Med Microbiol 1980; 13:273–280.Google Scholar
8.Boyer, KM, Gadzala, PD, Burd, LI. et al: Selective intrapartum chenioprophy-laxis of neonatal group B streptococcal early-onset disease. II. Predictive value of prenatal cultures. J Infect Dis 1983; 148:802–809.CrossRefGoogle Scholar
9.Pyati, SP. Pildes, RS, Jacobs, NM, et al: Penicillin in infants weighing two kilograms or less with early-onset group B streptococcal disease. N Engl J Med 1983:308:1383–1389.Google Scholar
10.Baker, CJ. Clark, DJ, Barrett, FF: Selective broth medium for isolation of group B streptococci. Applied Microbiology 1973; 26:884–885.Google Scholar
11.Dillon, HC Jr., Gray, E. Pass, MS, et al: Anorectal and vaginal carriage of group B streptococci during pregnancy. J Infect Dis 1982; 145:794–799.Google Scholar
12.Gardner, SE, Yow, MD, Leeds, LJ, el al: Failure of penicillin to eradicate group B streptococcal colonization in the pregnant woman. Am J Obstet Gynecol 1979; 135:1062–1065.Google Scholar
13.Lewin, EB, Amstey, MS: Natural history of group B streptococcus colonization and its therapy during pregnancy. Am J Obstet Gynecol 1981; 139:512–515.CrossRefGoogle ScholarPubMed
14.Merenstein, GB. Todd, WA, Brown, G, et al: Group B B-heniolytic streptococcus; randomized controlled treatment study al term. Obstet Gynecol 1980; 55:315–319.Google Scholar
15.Yow, MD, Mason, EO, Leeds, LJ. et al: Ampicillin prevents intrapartum transmission of group B streptococcus. JAMA 1979; 241:1245–1247.Google Scholar
16.Boyer, KM. Gadzala, CA. Kelly, PD, et al: Selective intrapartum chemoprophy-laxis of neonatal group B streptococcal early-onset disease. I. Interruption of mother-to-infant transmission. J Infect Dis 1983: 148:810–816.Google Scholar
17.Boyer, KM, Gotoff, SP, Gadzala, CA, el al: Selective intrapartum chemoprophy-laxis of early-onset group B streptococcal disease. J Pediatr Res 1984: 19:288A.Google Scholar
18.Sieigman, AJ, Bullone, EJ, Hanna, BA: Intramuscular penicillin administralion at birth: Prevention of early-onset group B streptococcal disease. Pediatrics 1978; 62:842–844.Google Scholar
19.Lloyd, DJ, Belgaumkar, TK, Scott, KE. el al: Prevention of group-B beta haemolytic streptococcal septicaemia in low-birth-weight neonates by penicillin administered within two hours of birth. Lancet 1979; 1:713–715.Google Scholar
20.Siegel, JD, McCracken, GM Jr., Threlkeld, N. et al: Single-dose penicillin prophylaxis against neonatal group B streptococcal infections: A controlled trial in 18,738 newborn infants. N Engl J Med 1980; 303:769–775.Google Scholar
21.Siegel, JD, McCracken, CM Jr., Threlkeld, N. et al: Single-dose penicillin prophylaxis of neonatal group B streptococcal disease: Conclusion of a 41-month controlled trial. Lancet 1982; 1:1426–1430.CrossRefGoogle Scholar
22.Baker, CJ, Kasper, DL: Correlation of maternal antibody deficiency with susceptibility to neonatal group B streptococcal infection. J Engl J Med 1976; 294:752–756.CrossRefGoogle ScholarPubMed
23.Baker, CJ, Edwards, MS. Kasper, DL: Role of antibody to native type III polysaccharide of group B Streptococcus. J Clin Invest 1978; 61:1107–1110.Google Scholar
24.Edwards, MS, Nicholson-Weller, A, Baker, CJ, et al: The role of specific antibody in alternative complement pathway-mediated opsonophagocytosis of type 111, group B Streptococcus. J Exp Med 1980; 151:1275–1287.Google Scholar
25.Vogel, LC. Kretschmcr, RR, Boyer, KM, et al: Human immunity to group B streptococci measured by indirect immunofluorescence: Correlation with protection in chick embryos. J Infect Dis 1979; 140:682–689.Google Scholar
26.Baltimore, RS, Baker, CJ, Kasper, DL: Antibody to group B Streptococcus type III in human sera measured by a mouse protection test. Infect Immun 1981; 32::56–61.Google Scholar
27.Shigeoka, AO, Mall, RT, Mill, HR: Blood-transfusion in group-B streptococcal sepsis. Lancet 1978; 1:636–638.CrossRefGoogle ScholarPubMed
28.Vain, NE, Mazlumina, JR, Swarmer, OW, et al: Role of exchange transfusion in the treatment of severe septicemia. Pediatrics 1980; 66:693–697.Google Scholar
29.Baker, CJ, Kasper, DL: Group B streptococcal vaccines. Rev Infect Dis 1985; 7:458–467.Google Scholar
30.Aber, RC, Allen, N, Howell, JT, el al: Nosocomial transmission of group, B streptococci. Pediatrics 1976; 58:346–353.Google Scholar
31.Band, JD, Clegg, HW, Hayes, PS, et al: Transmission of group B streptococci. Am J Dis Child 1981; 135:355–358.Google Scholar
32.Paredes, A, Wong, P. Mason, EO Jr., et al: Nosocomial transmission of group B streptococci in a newborn nursery. Pediatrics 1976; 59:579–682.Google Scholar
33.Anthony, BE, Okada, DM, Hobel, CJ: Epidemiology of the group B Streptococcus: Maternal and nosocomial sources for infant acquisitions. J Pediatr 1979: 95:431–436.Google Scholar
34.Easmon, CSF, Hastings, MJG, Clare, AJ, el al: Nosocomial iranstnission of group B streptococci. Br Med J 1981; 283:459–461.Google Scholar
35.Steere, AC, Aber, RC, Warford, LR, et al: Possible nosocomial transmission of group B streptococci in a newborn nursery. J Pediatr 1975; 87:784–787.Google Scholar
36.Wald, ER, Snyder, MJ, Gutberlet, RL: Group B B-hemolytic streptococcal colonization. Am J Dis Child 1975; 131:178–180.Google Scholar
37.Speck, WT. Driscol, JM, Polin, RA, et al: Siaphylococal and streptococcal colonization of the newborn infant. Effect of antiseptic cord care. Am J Dis Child 1977; 131:1005–1008.Google Scholar
38.Barrett, FF, Mason, EO Jr., Fleming, D: The effect of three cord-care regimens on bacterial colonization of normal newborn infants. J Pediatr 1979; 94:796–800.Google Scholar
39.Wong, P, Mason, EO Jr., Barrett, FF: Group B streptococcal colonization in a newborn nurserv: Effects of iodophor and triple dye cord care. South Med J 1977; 70:978–979.Google Scholar