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Policy statement backs CDC guidelines for preventing group B streptococcal disease

AAP COID. Pediatrics. 2011;doi:10.1542/peds.2011-1466.

Issue: September 2011

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Key changes to the CDC guidelines for preventing perinatal group B streptococcal disease, including use of intrapartum antibiotic prophylaxis, led to an 80% decline in the rate of disease and a revision to those guidelines.

The AAP recently released a policy statement on the recommendations for prevention of group B streptococcal. The CDC revised guidelines were released in 2010, but the AAP statement is intended to review and discuss the differences between the 2002 and 2010 guidelines that are most applicable to pediatricians.

The 2010 version of the CDC guidelines, which emphasizes further screening for this disease, will only help further those reductions, according to a policy statement published by Carol Baker, MD and colleagues from the AAP’s Committee on Infectious Diseases.

Baker and colleagues said women who are colonized with group B streptococcal are 25 times more likely to deliver a baby with early-onset infection compared with women who have a negative prenatal culture.

For the prevention of early-onset group B streptococcal, the CDC’s 2010 guidelines recommend the following for the management of newborn infants:

• Use of lumbar puncture in infants who have signs of sepsis or for babies born to women given a diagnosis of chorioamnionitis.
• Change in the use of prophylaxis; notably, use of ampicillin or cefazolin in women who cannot take penicillin, although penicillin is preferred.
• A revised algorithm for management of newborns with possible risk for early-onset group B streptococcal disease, specifically full evaluation of newborns with sepsis, including a lumbar puncture, routine care and 48-hour observation for infants born to women who received intrapartum antibiotic prophylaxis for 4 or more hours before delivery, and limited evaluation if the mother received inadequate intrapartum antibiotic prophylaxis and had membrane ruptures for more than 18 hours.

Disclosure: The researchers reported no relevant financial disclosures.

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