A National Consensus on Prevention of Early-Onset Group B Streptococcal Infection in the Newborn

A NATIONAL CONSENSUS STATEMENT ON THE PREVENTION of early-onset group B streptococcal (GBS) infections in the newborn was recently released by the Infectious Disease and Immunization Committee and the Fetus and Newborn Committee of the Canadian Paediatric Society in conjunction with the Maternal/ Fetal Medicine Committee of the Society of Obstetricians and Gynaecologists of Canada (1,2 and pages 251 to 256 in this issue of the Journal). This statement analyzes and summarizes the current state of knowledge about prevention of GBS infections and provides guidelines for management of pregnant. woman and their newborns. GBS continues to be a major source of sepsis in newborn infants who are infected before or during delivery. Prematurity, prolonged rupture of membranes, intrapartum fever and low socioeconomic status are among the risk factors of early-onset GBS disease. Of the various strategies attempted to reduce the incidence of disease (antimicrobial prophylaxis of the newborn. antepartum treatment of the colonized mother, passive immunization with immunoglobulin). only intrapartum chemoprophylaxis has been successful in decreasing the incidence of early-onset GBS disease (3). Identifying high risk pregnancies for intrapartum chemoprophylaxis has been problematic. Ideally, identification of high risk pregnancies at the time of delivery would permit selective chemoprophylaxis; however, the lack of a sufficiently sensitive rapid laboratory test to identifY colonized woman in labour do not