Selective or universal screening for GBS in pregnancy (review)

Group B streptococcus (GBS) is the most common cause of early-onset neonatal sepsis in many countries and responsible for significant perinatal morbidity and mortality worldwide. Intrapartum antibiotic prophylaxis has been the mainstay of efforts to prevent early-onset GBS disease in recent decades,...

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Bibliographic Details
Published in:Early human development 2018-11, Vol.126, p.18-22
Main Authors: Brown, Andrew P., Denison, Fiona C.
Format: Article
Language:English
Subjects:
Anti-Bacterial Agents - adverse effects
Anti-Bacterial Agents - therapeutic use
Female
Group B streptococcus
Humans
Incidence
Infant, Newborn
Intrapartum antibiotic prophylaxis
Mass Screening - methods
Microbial Sensitivity Tests
Neonatal Sepsis - microbiology
Neonatal Sepsis - prevention & control
Pregnancy
Pregnancy Complications, Infectious - diagnosis
Pregnancy Complications, Infectious - epidemiology
Risk Factors
Screening
Streptococcal Infections - epidemiology
Streptococcal Infections - prevention & control
Streptococcus agalactiae - pathogenicity
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Summary:Group B streptococcus (GBS) is the most common cause of early-onset neonatal sepsis in many countries and responsible for significant perinatal morbidity and mortality worldwide. Intrapartum antibiotic prophylaxis has been the mainstay of efforts to prevent early-onset GBS disease in recent decades, however it is unclear if women should be targeted based on the presence of clinical risk factors or by screening for GBS colonisation during pregnancy. Universal bacteriological screening of women in late pregnancy has been widely adopted but questions remain regarding its benefits and potential harms. Newer approaches to screening based on rapid point-of-care testing require further evaluation in randomised controlled trials to inform evidence-based practice. Given current preventive strategies do not protect against late onset disease and other sequelae of infection, maternal vaccination against GBS may present the best opportunity to reduce the global burden of invasive GBS disease in the future.
ISSN:0378-3782
1872-6232
DOI:10.1016/j.earlhumdev.2018.09.002