Positive Group B Streptococcus and the use of antimicrobial therapy in early neonatal period

Aim:

To determine the prevalence of positive Group B Streptococcus (GBS) and to evaluate the use of antimicrobial therapy in early neonatal period.

Materials and methods:

Retrospective case control study was performed by obtaining data from medical records in Riga Maternity Hospital from woman who had known GBS screening result and term delivery; woman were separated into two groups: GBS positive (697 patients, Group1) and GBS negative (755 patients, Group2). Data were analysed via SPSS v21.0.

Results:

In Group1 there were 76,6%(n = 534) vaginal deliveries, in Group2 – 77,7%(n = 587). In Group2 antibacterial intrapartum prophylaxis didn't receive 8,7%(n = 56) and it was insufficient in 9,6%(n = 62). Newborn were observed in NICU in 13,3% in Group1, 8,5% – in Group2; p = 0.003. Antibacterial therapy received 12,2% in Group1, 6,8% – Group2; p < 0.001. CRP was obtained in 94,4% in Group1 and 37,8% in Group2. Positive blood cultures were found in 0,1%(Group1) and 0,4%(Group2), with no cases of GBS. 99,1% newborns in Group1 and 98,7% in Group2 were discharged in normal condition.

Conclusions:

Newborns in Group1 more likely were observed in NICU and in this group CRP was analysed 2.5 times more frequently than in Group2, however CRP is not considered as a specific marker for the early diagnosis of infection in newborns. The administration of antibacterial therapy in the early neonatal period was more likely in Group1, however mostly they mothers had received broad spectrum antibacterial prophylaxis with Ampicillin during delivery, and that is why it's necessary to assess the need for antibacterial therapy in these cases.