Get access

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

Authors


  • DOI: 10.1111/j.1479-828X.2007.00760.x

Professor Warwick B. Giles, Division of Women's, Children's and Family Health, Royal North Shore Hospital, St Leonards, NSW 2065, Australia. Email: warwick.giles@newcastle.edu.au

Abstract

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% (χ2 = 5.75; P = 0.016). There was no difference in non-GBS disease (χ2 = 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.

Get access to the full text of this article

Ancillary