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Institution of universal screening for Group B streptococcus (GBS) from a risk management protocol results in reduction of early‐onset GBS disease in a tertiary obstetric unit
Author(s) -
ANGSTETRA Donald,
FERGUSON John,
GILES Warwick B.
Publication year - 2007
Publication title -
australian and new zealand journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.734
H-Index - 65
eISSN - 1479-828X
pISSN - 0004-8666
DOI - 10.1111/j.1479-828x.2007.00760.x
Subject(s) - incidence (geometry) , medicine , group b , pediatrics , disease , obstetrics , optics , physics
Aim: To determine the effect of institution of a universal screening protocol as per CDC 2002 guidelines had on the incidence of early‐onset Group B streptococcal (GBS) and non‐GBS disease in a tertiary obstetric unit. Methods: A prospective study with historical control data reporting the incidence of early‐onset GBS and non‐GBS disease following institution of a universal screening strategy at John Hunter Hospital, Newcastle, Australia. We compared the incidence of early‐onset GBS and non‐GBS disease during prescreening (1994–2002) with screening period (2004 to June 2006). The outcome measure was the incidence of early‐onset GBS disease. We specifically reported the number of women needed to treat (NNT) with antibiotics and the number of women needed to screen. Results: The incidence of early‐onset GBS and non‐GBS during the prescreening period was 0.84/1000 and 0.94/1000 live births, respectively. After institution of universal screening, the incidence was 0.00/1000 and 0.72/1000 live births, respectively. This is a statistically significant reduction in early‐onset GBS disease by 84% (χ 2 = 5.75; P = 0.016 ). There was no difference in non‐GBS disease (χ 2 = 0.14; P = 0.71 ). The NNT is 1191 and we needed to screen 5704 women to prevent one case of early‐onset GBS disease. Conclusion: Screening for GBS rather than by assessing risk factors has significantly reduced the incidence of early‐onset GBS disease in our unit. Despite low incidence of early‐onset GBS prior to screening period, we still found a significant decrease in early‐onset GBS disease after institution of universal screening protocol. These results support the screening‐based approach at 34–37 weeks gestation.