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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
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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

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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