Original Article
A Population-Based Comparison of Strategies to Prevent Early-Onset Group B Streptococcal Disease in Neonates
N Engl J Med 2002; 347:233-239July 25, 2002
- Abstract
Background
Guidelines issued in 1996 in the United States recommend either screening of pregnant women for group B streptococcal colonization by means of cultures (screening approach) or assessing clinical risk factors (risk-based approach) to identify candidates for intrapartum antibiotic prophylaxis.
Methods
In a multistate retrospective cohort study, we compared the effectiveness of the screening and risk-based approaches in preventing early-onset group B streptococcal disease (in infants less than seven days old). We studied a stratified random sample of the 629,912 live births in 1998 and 1999 in eight geographical areas where there was active surveillance for group B streptococcal infection, including all births in which the neonate had early-onset disease. Women with no documented culture for group B streptococcus were considered to have been cared for according to the risk-based approach.
Results
We studied 5144 births, including 312 in which the newborn had early-onset group B streptococcal disease. Antenatal screening was documented for 52 percent of the mothers. The risk of early-onset disease was significantly lower among the infants of screened women than among those in the risk-based group (adjusted relative risk, 0.46; 95 percent confidence interval, 0.36 to 0.60). Because women whose providers had no strategy for prophylaxis may have been misclassified in the risk-based group, we excluded all women with risk factors and adequate time for prophylaxis who did not receive antibiotics. The adjusted relative risk of early-onset disease associated with the screening approach in this secondary analysis was similar — 0.48 (95 percent confidence interval, 0.37 to 0.63).
Conclusions
Routine screening for group B streptococcus during pregnancy prevents more cases of early-onset disease than the risk-based approach. Recommendations that endorse both strategies as equivalent warrant reconsideration.
Media in This Article
Figure 1
Proportion of Women in the Screened Group and the Risk-Based Group with Indications for Chemoprophylaxis Who Received Intrapartum Antibiotics.Table 1
Characteristics of the Women in the Screened and Risk-Based Groups.Article Activity
- Article
The use of intrapartum prophylaxis with antibiotics to prevent perinatal group B streptococcal infections has led to a 70 percent decline in the incidence of group B streptococcal disease during the past decade.1,2 However, despite this dramatic decrease, early-onset group B streptococcal disease (in infants less than seven days old) remains a leading infectious cause of illness and death among newborns in the United States, resulting in approximately 1600 illnesses and 80 deaths annually.1 Surviving infants may have long-term developmental disabilities, such as mental retardation or hearing or vision loss.
Current guidelines for prevention, issued in 1996 by the American College of Obstetricians and Gynecologists, the American Academy of Pediatrics, and the Centers for Disease Control and Prevention (CDC), recommend that health care providers use either a risk-based or a screening approach to identify candidates for intrapartum antibiotic prophylaxis.3-5 With the risk-based approach, women presenting at the time of labor with clinical risk factors for disease transmission (including fever, a prolonged interval between rupture of the membranes and delivery, or preterm delivery) are offered intrapartum antibiotic prophylaxis. With the screening approach, women are screened for carriage of group B streptococcus between 35 and 37 weeks of gestation, and intrapartum chemoprophylaxis is offered to carriers. With both approaches, antibiotics are given during labor to women who had group B streptococcal bacteriuria during their current pregnancy, or who have previously had an infant with known group B streptococcal disease.
However, data are lacking on the relative effectiveness of these two strategies. Whereas population-based estimates of the proportion of infants with early-onset group B streptococcal disease who are born to mothers without clinical risk factors6 suggested that the screening approach would lead to greater declines in the incidence of disease than the risk-based approach,6,7 implementation of the risk-based approach is considered simpler than screening. Since 1996, both approaches have been recommended as equally acceptable, pending further data.3-5
We conducted a multistate, retrospective cohort study in a population of over 600,000 live-born infants to evaluate the effectiveness of the screening approach relative to the risk-based approach in preventing early-onset group B streptococcal disease.
Methods
Population
Our target population consisted of infants born in 1998 and 1999 to residents of selected areas (see the Appendix) of the Active Bacterial Core Surveillance program of the Emerging Infections Program Network of the CDC.8 Almost 100 percent of the hospitals that provide obstetrical services in these areas participate in the surveillance program. Only births that occurred in participating hospitals were included.
Study Approval
The study protocol was approved by an institutional review board of the CDC, and a waiver of informed consent was granted. Appropriate local institutional review boards also reviewed the protocol and either approved it or determined that it was exempt from the requirement for approval.
Sampling Design
A stratified random sample of births was drawn from birth-registry data. Strata were defined according to the surveillance area, the year, and the birth hospital. At least 500 births were selected per surveillance area to allow for accurate area-specific estimates. All surveillance-area hospitals with at least 10 births per year were included in the sampling frame. Within each stratum, births were sampled by proportional allocation; for small hospitals, at least 10 births that occurred during the two-year period were selected. All births of infants who had early-onset invasive infection were included in the sample. Invasive cases were defined by the isolation of group B streptococcus from a normally sterile site and were identified as part of routine population-based surveillance.8
Within strata, a constant statistical weight was assigned to each birth according to the inverse of its probability of selection; all births of infants with early-onset invasive infection were assigned a weight of 1 because all such births were included. Weights were adjusted to account for nonresponse (i.e., births without abstracted charts). The adjustment for nonresponse assumed that the births with abstracted charts within each stratum were representative of the entire stratum. The weights within each surveillance area and birth year were further adjusted so that the total number of preterm births represented the number of preterm births in the overall population.9,10
Data Collection
Trained abstracters reviewed the labor and delivery records for births in our sample using a standardized one-page form that included information on the following variables: demographic characteristics of the mother, adequacy of prenatal care, and the presence or absence of screening for group B streptococcus, clinical risk factors (i.e., gestation of less than 37 weeks, rupture of the membranes ≥18 hours before delivery, intrapartum temperature ≥38°C, group B streptococcal bacteriuria, previous infant with group B streptococcal disease), and intrapartum antibiotic use. In addition, data on the mother's race and ethnic background and the gestational age of the infant at birth (determined on the basis of the date of the last menstrual period) were collected from birth-registry files in each surveillance area. Abstracters were blinded to the disease status of the infant. For 21 cases of early-onset disease for which labor and delivery records were not available, we incorporated data on screening for group B streptococcus and intrapartum history collected as part of routine surveillance in the Active Bacterial Core Surveillance program.1
We assigned births to the screened or risk-based group using the following algorithm: any mother with documentation in the labor and delivery record (either in the admission record or in the prenatal records forwarded to the hospital) of a group B streptococcal culture performed at least two days before delivery was categorized in the screened group. All mothers without documentation of a test for group B streptococcus that adhered to the above criteria were categorized in the risk-based group. This categorization was based on the results of a recent national survey showing that 98 percent of obstetricians have a policy for the prevention of group B streptococcal disease that is a version of either the risk-based approach or the screening approach.11
Definitions of Variables
Preterm delivery was defined as delivery at less than 37 weeks of estimated gestation. Intrapartum was defined as occurring during the period between the onset of labor or the rupture of the membranes and delivery. For infants delivered by cesarean section, intrapartum was defined as occurring during the period between admission for delivery and cord clamping. Adequacy of prenatal care was determined by the Kessner Index, which categorizes prenatal care as inadequate, intermediate, or adequate on the basis of the timing of the initiation of prenatal care, the gestational age at delivery, and the number of visits for prenatal care.12 For univariate and multivariable models, we used only two categories: inadequate and not inadequate.
Statistical Analysis
All analyses were conducted with the use of weights to account for unequal probability of selection. Data were analyzed with SUDAAN software (version 7.5.6, Research Triangle Institute) to account for the stratified survey design. Weighted values are reported.
The risk of early-onset disease in the screened group relative to the risk-based group was evaluated by univariate and multivariable models in which the disease status of the infant was the dependent variable. All variables that were associated with disease at a significance level of less than 0.15 in univariate models, as well as variables identified in previous studies as risk factors for early-onset disease, were considered in multivariable models with the use of PROC MULTILOG. The final multivariable model included main effects with a significance level of less than 0.05. All two-way interactions of main effects were evaluated. The efficacy of intrapartum antibiotic prophylaxis (calculated as 1 – the relative risk) was evaluated in univariate models in which the disease status of the infant was the dependent variable and receipt of intrapartum antibiotics was the independent variable.
All P values are two-tailed. In multivariable analyses, odds ratios are assumed to approximate relative risks because early-onset disease was rare in this population.13
Results
Population
We reviewed the labor and delivery records for 5144 live births randomly sampled from a total of 629,912 in the surveillance areas in 1998 and 1999. A total of 95 percent of the births selected for inclusion had abstracted charts (5144 of 5425). The gestational age for one infant in the risk-based group was not known; this birth was excluded from analyses because sample weights took into account gestational age. Active surveillance for early-onset group B streptococcal disease identified 312 cases in 1998 and 1999, for an overall incidence of 0.5 case per 1000 live births. All 312 births were included in our study.
Among the women whose newborns had early-onset disease, 62 percent (195 of 312) did not have evidence of clinical risk factors for transmission of group B streptococcal disease. In the population as a whole, 52 percent of the women were screened for group B streptococcus before delivery; the proportion of women who were screened varied geographically from 24 percent in selected counties in Oregon to 70 percent in Maryland.
Characteristics of the screened and risk-based groups are summarized in Table 1Table 1
Characteristics of the Women in the Screened and Risk-Based Groups.. The risk-based group included a significantly greater proportion of Hispanics than the screened group; the risk-based approach was more common in surveillance areas (California and Oregon) that included the majority of Hispanic women in our population. Overall, 98.1 percent of the women had at least one prenatal visit; however, women in the risk-based group were less likely to have had prenatal care and more likely to deliver before term than women in the screened group (Table 1). In contrast, the screened group included higher proportions of women with group B streptococcal bacteriuria during pregnancy and women who had previously had an infant with group B streptococcal disease.Factors Associated with Early-Onset Group B Streptococcal Disease
According to the univariate analysis, prenatal screening for group B streptococcus was associated with a lower risk of early-onset disease than was the risk-based approach (relative risk, 0.48; 95 percent confidence interval, 0.38 to 0.61) (Table 2Table 2
Factors Associated with Early-Onset Group B Streptococcal Disease in the Univariate Analysis.). Intrapartum fever (temperature, ≥38°C) and having previously had an infant with group B streptococcal disease were the factors associated with the highest risk of early-onset disease. Hispanic ethnic background was not associated with an elevated risk of early-onset disease. Similarly, group B streptococcal bacteriuria during pregnancy was not associated with an increased risk of early-onset disease; however, 82 percent of all women with group B streptococcal bacteriuria received intrapartum antibiotics.Medicaid payment of costs for labor and delivery and inadequate prenatal care were predictors of early-onset group B streptococcal disease in the univariate, but not the multivariable, analyses (Table 2). In multivariable analyses, the screening approach remained associated with lower risk of early-onset disease relative to the risk-based approach (relative risk adjusted for other factors in the multivariable model, 0.46; 95 percent confidence interval, 0.36 to 0.60) (Table 2).
Evaluation of Potential Confounders
Because preterm delivery was more common in the risk-based group and was associated with an increased risk of early-onset disease, we performed a stratified analysis limited to full-term births. Results were similar to those in Table 2, and the protective effect of screening relative to the risk-based approach remained significant (adjusted relative risk, 0.44; 95 percent confidence interval, 0.33 to 0.58).
Similarly, because it is recommended that prenatal screening be performed at 35 to 37 weeks of gestation and prenatal charts may be forwarded to hospitals before this time, we performed a subgroup analysis including women whose prenatal records were forwarded after 37 weeks of gestation (accounting for 38 percent of births). In this subgroup, screening remained associated with a lower risk of early-onset disease (adjusted relative risk, 0.32; 95 percent confidence interval, 0.21 to 0.49).
Another concern is that women whose providers had no strategy for preventing group B streptococcal disease may have been misclassified in the risk-based group. We therefore excluded from this group all women with risk factors who did not receive intrapartum antibiotics and who were in the hospital for at least two hours before delivery, allowing for time for intervention. When the observations for these 207 women (30 of whom had infants with early-onset group B streptococcal disease) were excluded, the risk of early-onset disease remained lower in the screened group (adjusted relative risk, 0.48; 95 percent confidence interval, 0.37 to 0.63).
Factors Contributing to the Protective Effect of Screening
In the screened group, 416 women (weighted proportion, 18 percent) had a positive culture for group B streptococcus in the absence of fever, a prolonged interval between rupture of membranes and delivery (≥18 hours), or preterm delivery. The incidence of disease among the infants of culture-positive women without these risk factors who did not receive intrapartum chemoprophylaxis was 1.3 per 1000 live births (95 percent confidence interval, 0.3 to 2.8 per 1000). The efficacy of intrapartum antibiotics in preventing early-onset group B streptococcal disease in the infants of culture-positive women without clinical risk factors was high — 88.6 percent (95 percent confidence interval, 66.4 to 96.1 percent).
Women in the screened group who had indications for prophylaxis were also significantly more likely to receive intrapartum antibiotics than those in the risk-based group (89 percent vs. 61 percent, P<0.001) (Figure 1Figure 1
Proportion of Women in the Screened Group and the Risk-Based Group with Indications for Chemoprophylaxis Who Received Intrapartum Antibiotics.). The median interval between admission and delivery did not differ between groups (screened group, 7.9 hours; interquartile range, 3.8 to 13.7; risk-based group, 7.2 hours; interquartile range, 3.2 to 13.4). The median interval between the identification of a clinical risk factor and delivery among women with risk factors in the risk-based group was 10.6 hours (interquartile range, 4.5 to 23.4).We projected the effect of improved implementation of the risk-based approach by assuming that all women in the risk-based group who had clinical risk factors but did not receive prophylaxis had actually received intrapartum antibiotics and that the efficacy of prophylaxis was 86 percent.14 Under this assumption, the incidence of early-onset disease in the study surveillance areas would have decreased from 0.50 per 1000 live births to 0.44 per 1000 live births. This projected incidence, which assumes 100 percent compliance, remains higher than the observed incidence of early-onset disease among the infants of the screened women (0.32 per 1000 live births; 95 percent confidence interval, 0.26 to 0.38).
Anticipated Intrapartum Antibiotic Use under the Screening and Risk-Based Strategies
The proportion of deliveries to women colonized with group B streptococcus in the screened group (24 percent) did not differ from the proportion of women with risk factors in the risk-based group (24 percent). In the screened group, culture-negative women with fever (accounting for 2 percent of deliveries) also received intrapartum antibiotics. An additional 5 percent of the women in each group received intrapartum antibiotics that were most likely not given for prophylaxis against group B streptococcal disease; they did not have documented indications for prophylaxis. Thus, with perfect implementation of either preventive strategy, the anticipated overall rate of intrapartum antibiotic use would be similar (31 percent in the screened group, 29 percent in the risk-based group).
Discussion
Although the guidelines for the prevention of perinatal group B streptococcal disease that were issued in the United States in 1996 recommend the risk-based and screening approaches as equally acceptable, debate continues over whether both strategies are equally effective. Although there are now observational data suggesting that each strategy can reduce the incidence of early-onset disease,14-18 the strategies have not previously been directly compared. A series of single-hospital analyses19-22 have been limited by the sequential use of the strategies and the investigators' inability to control for potential confounders. By incorporating data from multistate, population-based surveillance for early-onset disease into a sample survey of a population of over 600,000 live-born infants, we found that the screening approach was more than 50 percent more effective than the risk-based approach at preventing perinatal group B streptococcal disease.
The protective effect of the screening approach persisted when we controlled for recognized risk factors for early-onset disease.23-25 The protective effect of the screening approach also persisted when we controlled for factors such as prenatal care or preterm delivery that differed between groups, most likely because we assigned women with no documented culture to the risk-based group. Furthermore, because the effectiveness of screening was based on actual implementation of this strategy in the field, it is possible that improved compliance with recommendations for culture collection and processing will result in further benefits.
The protective effect of screening stemmed from two main factors. First, by identifying women colonized with group B streptococcus who did not present with clinical risk factors, screening achieved a higher degree of coverage of the at-risk population than the risk-based approach. In the screened group, 18 percent of all deliveries were to culture-positive women without risk factors. The incidence of disease among infants of culture-positive women without risk factors who did not receive intrapartum prophylaxis was 1.3 per 1000 live births; in the era before prevention, the incidence of disease among such infants was as high as 5.1 per 1000 live births.26 The efficacy of intrapartum antibiotics in preventing early-onset disease among infants of culture-positive women without risk factors was also close to 90 percent.
Women in the screened group who were culture-positive were also more likely to receive intrapartum antibiotics than women with clinical risk factors in the risk-based group. This difference was not explained by a greater opportunity to administer chemoprophylaxis in the screened group; the interval between the first appearance of a clinical risk factor and delivery in the risk-based group was greater than the median interval between admission and delivery in the screened group.
It is possible that the lower rate of use of intrapartum antibiotics in the risk-based group reflects the inclusion in this group of some women whose providers had no strategy for prevention. However, the proportion of women in the risk-based group who received intrapartum antibiotics15 was similar to that reported in the literature for institutions implementing the risk-based approach. In addition, even perfect implementation of the risk-based approach is not likely to lead to declines in the incidence of disease as great as those achieved with universal screening. This conclusion is supported both by a secondary analysis in which we excluded from the risk-based group all women with missed opportunities for prophylaxis and by projection of the incidence of disease in the risk-based group that would result from the provision of intrapartum antibiotics to all mothers of infants with early-onset disease who had had clinical risk factors but had not received intrapartum antibiotics.
The increased use of intrapartum chemoprophylaxis to prevent group B streptococcal disease has raised concern about potential adverse consequences of antibiotic use. However, our observation that anticipated intrapartum antibiotic use is similar with the two strategies suggests that the potential for adverse effects of chemoprophylaxis is also similar.
The absence of a significant association between group B streptococcal bacteriuria and early-onset disease that is reported here should not be taken as evidence that such bacteriuria is no longer an important indication for prophylaxis. Rather, we interpret this absence of association as evidence of successful prevention, since 82 percent of women with bacteriuria received intrapartum prophylaxis.
National policies for the prevention of group B streptococcal disease must take into account the effectiveness of different strategies, the risk of adverse or unintended consequences of preventive strategies, and the practical challenges involved in implementation. Our finding that screening was more effective than the risk-based approach in preventing early-onset disease in a large, multistate population suggests that a recommendation for universal screening warrants further consideration.
Supported by the Office of Women's Health of the CDC and by the Antimicrobial Resistance Program and the Emerging Infections Program of the National Center for Infectious Diseases.
We are indebted to the other members of the Active Bacterial Core Surveillance team: P. Daily, R. Proctor, and M. Nixon in California; J. Hadler and H. Linardos in Connecticut; W. Baughman, J. Carter, K. Bryant, M.M. Farley, C. Gordon, P. Martell-Cleary, and R. Subbarao in Georgia; A. Bustamante and M. Pass in Maryland; C. Olson, J. Rainbow, and K. White in Minnesota; N. Bennett, B. Damaske, and S. Zansky in New York; P. Cieslak, E. Lorber, and T. McGivern in Oregon; and T. Hilger and K. Robinson at the CDC.
Source Information
From the Centers for Disease Control and Prevention, Atlanta (S.J.S., E.R.Z., M.G., A.S.); the Minnesota Department of Health, Minneapolis (R.L.); the Connecticut Department of Public Health, Hartford (A. Roome); the Georgia Department of Human Resources, Atlanta (K.E.A.); the Tennessee Department of Health, Nashville (A.S.C.); Johns Hopkins University Bloomberg School of Public Health, Baltimore (L.H.H.); the School of Public Health, University of California at Berkeley, Berkeley (A. Reingold); the Department of Human Services–Health Services, Portland, Oreg. (K.S.); and the New York Department of Health, Albany (G.S.).
Address reprint requests to Dr. Schrag at the Respiratory Diseases Branch, MS-C23, Division of Bacterial and Mycotic Disease, Centers for Disease Control and Prevention, 1600 Clifton Rd., Atlanta, GA 30333, or at zha6@cdc.gov.
Appendix
Study locations included Maryland, 3 California counties (Alameda, Contra Costa, and San Francisco), 20 counties in the metropolitan area of Atlanta, 5 Tennessee counties (Davidson, Hamilton, Knox, Shelby, and Williamson), Connecticut, 3 Oregon counties (Clackamas, Multnomah, and Washington), 7 Minnesota counties (Anoka, Carver, Dakota, Hennepin, Ramsey, Scott, and Washington), and 7 New York counties (Genesee, Livingston, Monroe, Ontario, Orleans, Wayne, and Yates).
- References
References
1
Early-onset group B streptococcal disease -- United States, 1998-1999. MMWR Morb Mortal Wkly Rep 2000;49:793-796
2
Schrag SJ ,Zywicki S ,Farley MM , et al. Group B streptococcal disease in the era of intrapartum antibiotic prophylaxis. N Engl J Med 2000;342:15-20
Full Text | Web of Science | Medline3
Committee on Obstetric Practice. Prevention of early-onset group B streptococcal disease in newborns. Washington, D.C.: American College of Obstetricians and Gynecologists, 1996.
4
American Academy of Pediatrics Committee on Infectious Diseases, Committee on Fetus and Newborn
CrossRef | Web of Science | Medline5
Prevention of perinatal group B streptococcal disease: a public health perspective. MMWR Morb Mortal Wkly Rep 1996;45:1-24[Erratum, MMWR Morb Mortal Wkly Rep 1996;45:679.]
Medline6
Rosenstein NE ,Schuchat A . Opportunities for prevention of perinatal group B streptococcal disease: a multistate surveillance analysis. Obstet Gynecol 1997;90:901-906
CrossRef | Web of Science | Medline7
Rouse DJ ,Goldenberg RL ,Cliver SP ,Cutter GR ,Mennemeyer ST ,Fargason CA Jr . Strategies for the prevention of early-onset neonatal group B streptococcal sepsis: a decision analysis. Obstet Gynecol 1994;83:483-494
CrossRef | Web of Science | Medline8
Schuchat A ,Hilger T ,Zell E , et al. Active Bacterial Core surveillance of the Emerging Infections Program Network. Emerg Infect Dis 2001;7:92-99
CrossRef | Web of Science | Medline9
Lohr SL. Sampling: design and analysis. Pacific Grove, Calif.: Duxbury Press, 1999.
10
Cochran WG. Sampling techniques. 2nd ed. New York: John Wiley, 1963:413.
11
Watt JP ,Schuchat A ,Erickson K ,Honig JE ,Gibbs R ,Schulkin J . Group B streptococcal disease prevention practices of obstetrician-gynecologists. Obstet Gynecol 2001;98:7-13
CrossRef | Web of Science | Medline12
Kotelchuck M . An evaluation of the Kessner Adequacy of Prenatal Care Index and a proposed Adequacy of Prenatal Care Utilization Index. Am J Public Health 1994;84:1414-1420
CrossRef | Web of Science | Medline13
Armitage P, Berry G. Statistical methods in medical research. 3rd ed. Malden, Mass.: Blackwell Science, 1994:621.
14
Lin FYC ,Brenner RA ,Johnson YR , et al. The effectiveness of risk-based intrapartum chemoprophylaxis for the prevention of early-onset neonatal group B streptococcal disease. Am J Obstet Gynecol 2001;184:1204-1210
CrossRef | Web of Science | Medline15
Factor SH ,Levine OS ,Nassar A , et al. Impact of a risk-based prevention policy on neonatal group B streptococcal disease. Am J Obstet Gynecol 1998;179:1568-1571
CrossRef | Web of Science | Medline16
Lieu TA ,Mohle-Boetani JC ,Ray GT ,Ackerson LM ,Walton DL . Neonatal group B streptococcal infection in a managed care population. Obstet Gynecol 1998;92:21-27
CrossRef | Web of Science | Medline17
Levine EM ,Ghai V ,Barton JJ ,Strom CM . Intrapartum antibiotic prophylaxis increases the incidence of gram-negative neonatal sepsis. Infect Dis Obstet Gynecol 1999;7:210-213
CrossRef | Medline18
Reisner DP ,Haas MJ ,Zingheim RW ,Williams MA ,Luthy DA . Performance of a group B streptococcal prophylaxis protocol combining high-risk treatment and low-risk screening. Am J Obstet Gynecol 2000;182:1335-1343
CrossRef | Web of Science | Medline19
Hafner E ,Sterniste W ,Rosen A , et al. Group B streptococci during pregnancy: a comparison of two screening and treatment protocols. Am J Obstet Gynecol 1998;179:677-681
CrossRef | Web of Science | Medline20
Locksmith GJ ,Clark P ,Duff P . Maternal and neonatal infection rates with three different protocols for prevention of group B streptococcal disease. Am J Obstet Gynecol 1999;180:416-422
CrossRef | Web of Science | Medline21
Gilson GJ ,Christensen F ,Romero H ,Bekes K ,Silva L ,Qualls CR . Prevention of group B streptococcus early-onset neonatal sepsis: comparison of the Centers for Disease Control and Prevention screening-based protocol to a risk-based protocol in infants at greater than 37 weeks' gestation. J Perinatol 2000;20:491-495
CrossRef | Medline22
Main EK ,Slagle T . Prevention of early-onset invasive group B streptococcal disease in a private hospital setting: the superiority of culture-based protocols. Am J Obstet Gynecol 2000;182:1344-1354
CrossRef | Web of Science | Medline23
Ancona RJ ,Ferrieri P ,Williams PP . Maternal factors that enhance the acquisition of group B streptococci by newborn infants. J Med Microbiol 1980;13:273-280
CrossRef | Web of Science | Medline24
Dillon HC Jr ,Khare S ,Gray BM . Group B streptococcal carriage and disease: a 6-year prospective study. J Pediatr 1987;110:31-36
CrossRef | Web of Science | Medline25
Schuchat A ,Oxtoby M ,Cochi S , et al. Population-based risk factors for neonatal group B streptococcal disease: results of a cohort study in metropolitan Atlanta. J Infect Dis 1990;162:672-677
CrossRef | Web of Science | Medline26
Boyer KM ,Gotoff SP . Strategies for chemoprophylaxis of GBS early-onset infections. Antibiot Chemother 1985;35:267-280
Medline
- Citing Articles (115)
Citing Articles
1
Vanessa Clifford, Suzanne M Garland, Keith Grimwood. (2012) Prevention of neonatal group B streptococcus disease in the 21st century. Journal of Paediatrics and Child Healthno-no
CrossRef2
Susan L. Lukacs, Stephanie J. Schrag. (2012) Clinical Sepsis in Neonates and Young Infants, United States, 1988-2006. The Journal of Pediatrics
CrossRef3
Egle Barcaite, Arnoldas Bartusevicius, Rasa Tameliene, Laima Maleckiene, Astra Vitkauskiene, Ruta Nadisauskiene. (2012) Group B streptococcus and Escherichia coli colonization in pregnant women and neonates in Lithuania. International Journal of Gynecology & Obstetrics
CrossRef4
Karen M Edmond, Christina Kortsalioudaki, Susana Scott, Stephanie J Schrag, Anita KM Zaidi, Simon Cousens, Paul T Heath. (2012) Group B streptococcal disease in infants aged younger than 3 months: systematic review and meta-analysis. The Lancet
CrossRef5
Emily J. Weston, Tracy Pondo, Melissa M. Lewis, Pat Martell-Cleary, Craig Morin, Brenda Jewell, Pam Daily, Mirasol Apostol, Sue Petit, Monica Farley, Ruth Lynfield, Art Reingold, Nellie I. Hansen, Barbara J. Stoll, Andi J. Shane, Elizabeth Zell, Stephanie J. Schrag. (2011) The Burden of Invasive Early-onset Neonatal Sepsis in the United States, 2005–2008. The Pediatric Infectious Disease Journal 30:11, 937-941
CrossRef6
M. Kathryn Menard. 2011. Group B Streptococcus. , 263-268.
CrossRef7
Brett C. Young, Laura E. Dodge, Munish Gupta, Julie S. Rhee, Michele R. Hacker. (2011) Evaluation of a rapid, real-time intrapartum group B streptococcus assay. American Journal of Obstetrics and Gynecology 205:4, 372.e1-372.e6
CrossRef8
Karen L. Trappe, Lynn E. T. Shaffer, Laurence E. Stempel. (2011) Vaginal–Perianal Compared With Vaginal–Rectal Cultures for Detecting Group B Streptococci During Pregnancy. Obstetrics & Gynecology 118:2, Part 1, 313-317
CrossRef9
Liat Ashkenazi-Hoffnung, Gilat Livni, Jacob Amir, Efraim Bilavsky. (2011) Serious bacterial infections in hospitalized febrile infants aged 90 days or younger: The traditional combination of ampicillin and gentamicin is still appropriate. Scandinavian Journal of Infectious Diseases 43:6-7, 489-494
CrossRef10
R. Witt, P. M. Oostvogel, R. Yahiaoui, Y. Wu, A. Belkum, A. E. Muller. (2011) In vitro evaluation of the performance of Granada selective enrichment broth for the detection of group B streptococcal colonization. European Journal of Clinical Microbiology & Infectious Diseases
CrossRef11
O. Schneewind, D. Missiakas. (2011) Structural vaccinology to thwart antigenic variation in microbial pathogens. Proceedings of the National Academy of Sciences 108:25, 10029-10030
CrossRef12
P. Melin. (2011) Neonatal group B streptococcal disease: from pathogenesis to preventive strategies. Clinical Microbiology and Infectionno-no
CrossRef13
E. Ben Hamida Nouaili, K. Abidi, S. Chaouachi, Z. Marrakchi. (2011) Épidémiologie des infections materno-fœtales à streptocoque du groupe B. Médecine et Maladies Infectieuses 41:3, 123-125
CrossRef14
M. Abdelmaaboud, A. F. Mohammed. (2011) Universal Screening vs. Risk-based Strategy for Prevention of Early-onset Neonatal Group-B Streptococcal Disease. Journal of Tropical Pediatrics
CrossRef15
Oscar Esparcia, Michel Montemayor, Gemma Ginovart, Virginia Pomar, Germán Soriano, Roser Pericas, Mercedes Gurgui, Elena Sulleiro, Guillem Prats, Ferran Navarro, Pere Coll. (2011) Diagnostic accuracy of a 16S ribosomal DNA gene-based molecular technique (RT-PCR, microarray, and sequencing) for bacterial meningitis, early-onset neonatal sepsis, and spontaneous bacterial peritonitis. Diagnostic Microbiology and Infectious Disease 69:2, 153-160
CrossRef16
María Gema Codina, Marina de Cueto, Diego Vicente, Juan Emilio Echevarría, Guillem Prats. (2011) Diagnóstico microbiológico de las infecciones del sistema nervioso central. Enfermedades Infecciosas y Microbiología Clínica 29:2, 127-134
CrossRef17
Morven S. Edwards, Victor Nizet. 2011. Group B Streptococcal Infections. , 419-469.
CrossRef18
Alice R Rumbold, Ross S Bailie, Damin Si, Michelle C Dowden, Catherine M Kennedy, Rhonda J Cox, Lynette O'Donoghue, Helen E Liddle, Ru K Kwedza, Sandra C Thompson, Hugh P Burke, Alex DH Brown, Tarun Weeramanthri, Christine M Connors. (2011) Delivery of maternal health care in Indigenous primary care services: baseline data for an ongoing quality improvement initiative. BMC Pregnancy and Childbirth 11:1, 16
CrossRef19
Sigurður Árnason, Valtýr Stefánsson Thors, Thórólfur Guðnason, Karl G. Kristinsson, Ásgeir Haraldsson. (2010) Bacteraemia in children in Iceland 1994-2005. Acta Paediatrica 99:10, 1531-1535
CrossRef20
Pierre Kuhn, Céline Dheu, Chantal Bolender, Didier Chognot, Laurence Keller, Houria Demil, Lionel Donato, Bruno Langer, Jean Messer, Dominique Astruc. (2010) Incidence and distribution of pathogens in early-onset neonatal sepsis in the era of antenatal antibiotics. Paediatric and Perinatal Epidemiology 24:5, 479-487
CrossRef21
Brenna Anderson, Melissa Gaitanis, Daniel I. Sessler. 2010. Nonviral Infectious Diseases in Pregnancy. , 404-430.
CrossRef22
Mara J. Dinsmoor. 2010. Group B Streptococcus. , 334-339.
CrossRef23
William P. Goins, Thomas R. Talbot, William Schaffner, Kathryn M. Edwards, Allen S. Craig, Stephanie J. Schrag, Melissa K. Van Dyke, Marie R. Griffin. (2010) Adherence to Perinatal Group B Streptococcal Prevention Guidelines. Obstetrics & Gynecology 115:6, 1217-1224
CrossRef24
James L. Wynn, Ofer Levy. (2010) Role of Innate Host Defenses in Susceptibility to Early-Onset Neonatal Sepsis. Clinics in Perinatology 37:2, 307-337
CrossRef25
Jennifer R. Verani, Stephanie J. Schrag. (2010) Group B Streptococcal Disease in Infants: Progress in Prevention and Continued Challenges. Clinics in Perinatology 37:2, 375-392
CrossRef26
Catherine Ison. 2010. Bacterial Infections of the Genital Tract. .
CrossRef27
Mahboobeh Nakhaei Mo. (2010) Recto-Vaginal Colonization of Group B Streptococcus in Pregnant Women Referred to a Hospital in Iran and its Effect on Lactobacillus Normal Flora. Journal of Biological Sciences 10:2, 166-169
CrossRef28
R J Powers, D Wirtschafter. (2010) Prevention of Group B Streptococcus early-onset disease: a toolkit by the California Perinatal Quality Care Collaborative. Journal of Perinatology 30:2, 77-87
CrossRef29
Susan M. Sayers. (2009) Indigenous Newborn Care. Pediatric Clinics of North America 56:6, 1243-1261
CrossRef30
Alison G. Cahill, Anthony O. Odibo, David M. Stamilio, George A. Macones. (2009) Screening and treating for primary cytomegalovirus infection in pregnancy: where do we stand? A decision-analytic and economic analysis. American Journal of Obstetrics and Gynecology 201:5, 466.e1-466.e7
CrossRef31
María José Centelles-Serrano, Mar Olga Pérez-Moreno, María Isabel Llovet-Lombarte, María Cortell-Ortolá, Anna Maria Jardí-Baiges, José Ignacio Buj-González. (2009) Impacto de la investigación sistemática de estreptococo del grupo B en orina en la identificación de gestantes colonizadas. Enfermedades Infecciosas y Microbiología Clínica 27:7, 394-398
CrossRef32
Arne Ohlsson, Vibhuti S Shah, Arne Ohlsson. 2009. Intrapartum antibiotics for known maternal Group B streptococcal colonization. .
CrossRef33
Van Dyke, Melissa K., Phares, Christina R., Lynfield, Ruth, Thomas, Ann R., Arnold, Kathryn E., Craig, Allen S., Mohle-Boetani, Janet, Gershman, Ken, Schaffner, William, Petit, Susan, Zansky, Shelley M., Morin, Craig A., Spina, Nancy L., Wymore, Kathryn, Harrison, Lee H., Shutt, Kathleen A., Bareta, Joseph, Bulens, Sandra N., Zell, Elizabeth R., Schuchat, Anne, Schrag, Stephanie J., . (2009) Evaluation of Universal Antenatal Screening for Group B Streptococcus. New England Journal of Medicine 360:25, 2626-2636
Full Text34
Katalin Kristóf, Erika Kocsis, K. Nagy. (2009) Clinical microbiology of early-onset and late-onset neonatal sepsis, particularly among preterm babies. Acta Microbiologica et Immunologica Hungarica 56:1, 21-51
CrossRef35
Crystal J. Redfern, Robert L. Sautter. (2009) Near-Patient Testing for Group B Streptococci Screening. Point of Care: The Journal of Near-Patient Testing & Technology 8:1, 25-28
CrossRef36
Alma-Verena Rausch, Ariane Gross, Sara Droz, Thomas Bodmer, Daniel V. Surbek. (2009) Group B Streptococcus colonization in pregnancy: prevalence and prevention strategies of neonatal sepsis. Journal of Perinatal Medicine 37:2, 124-129
CrossRef37
Mark A. Turrentine, Mildred M. Ramirez, Joan M. Mastrobattista. (2009) Cost-Effectiveness of Universal Prophylaxis in Pregnancy with Prior Group B Streptococci Colonization. Infectious Diseases in Obstetrics & Gynecology 2009, 1-11
CrossRef38
Sarah Ahmed Abd El-kawy Shabayek, Salah Mohamed Abdalla, Abouzeid M.H. Abouzeid. (2009) Vaginal carriage and antibiotic susceptibility profile of group B Streptococcus during late pregnancy in Ismailia, Egypt. Journal of Infection and Public Health 2:2, 86-90
CrossRef39
Hannah T. Jordan, Monica M. Farley, Allen Craig, Janet Mohle-Boetani, Lee H. Harrison, Susan Petit, Ruth Lynfield, Ann Thomas, Shelley Zansky, Kenneth Gershman, Bernadette A. Albanese, William Schaffner, Stephanie J. Schrag. (2008) Revisiting the Need for Vaccine Prevention of Late-Onset Neonatal Group B Streptococcal Disease. The Pediatric Infectious Disease Journal 27:12, 1057-1064
CrossRef40
K. M. Puopolo. (2008) Epidemiology of Neonatal Early-onset Sepsis. NeoReviews 9:12, e571-e579
CrossRef41
Arne Ohlsson, Vibhuti S Shah, Arne Ohlsson. 2008. Intrapartum antibiotics for known maternal Group B streptococcal colonisation. .
CrossRef42
FD Schouten, H Wolf, BJ Smit, DJ Bekedam, R de Vos, I Wahlen. (2008) Maternal temperature during labour. BJOG: An International Journal of Obstetrics & Gynaecology 115:9, 1131-1137
CrossRef43
Asmaa Tazi, Hélène Réglier-Poupet, François Dautezac, Josette Raymond, Claire Poyart. (2008) Comparative evaluation of Strepto B ID®chromogenic medium and Granada media for the detection of Group B streptococcus from vaginal samples of pregnant women. Journal of Microbiological Methods 73:3, 263-265
CrossRef44
C. Thibaudon Baveux, A. Stroebel Noguer, I. Boulard Mallet, M. Djavadzadeh-Amini, N. Kacet, P. Truffert, D. Subtil, J.-P. Dubos. (2008) Prévention des infections bactériennes néonatales précoces à streptocoque B. Journal de Gynécologie Obstétrique et Biologie de la Reproduction 37:4, 392-399
CrossRef45
Rodney K. Edwards, Susan M. Novak-Weekley, Patrick P. Koty, Thomas Davis, Leroy J. Leeds, Jeanne A. Jordan. (2008) Rapid Group B Streptococci Screening Using a Real-Time Polymerase Chain Reaction Assay. Obstetrics & Gynecology 111:6, 1335-1341
CrossRef46
S. Mansouri, E. Ghasami, N. Shahabi Najad. (2008) Vaginal Colonization of Group B Streptococci During Late Pregnancy in Southeast of Iran: Incidence, Serotype Distribution and Susceptibility to Antibiotics. Journal of Medical Sciences(Faisalabad) 8:6, 574-578
CrossRef47
John W. Larsen, John L. Sever. (2008) Group B Streptococcus and pregnancy: a review. American Journal of Obstetrics and Gynecology 198:4, 440-450
CrossRef48
Antonette T. Dulay, Irina A. Buhimschi, Guomao Zhao, Guoyang Luo, Sonya Abdel-Razeq, Michael Cackovic, Victor A. Rosenberg, Christian M. Pettker, Stephen F. Thung, Mert O. Bahtiyar, Vineet Bhandari, Catalin S. Buhimschi. (2008) Nucleated red blood cells are a direct response to mediators of inflammation in newborns with early-onset neonatal sepsis. American Journal of Obstetrics and Gynecology 198:4, 426.e1-426.e9
CrossRef49
Anne‐Marie Dumas, Raphaëlle Girard, Louis Ayzac, Geneviève Beaumont, Emmanuelle Caillat‐Vallet, Florence Depaix, Chantal Gignoux, Catherine Haond, Noelle Pral, Jacqueline Robert, Françoise Tissot‐Guerraz, Agnès Vincent‐Bouletreau, Michel Berland, Jacques Fabry. (2008) Effect of Intrapartum Antibiotic Prophylaxis Against Group B Streptococcal Infection on Comparisons of Rates of Endometritis and Urinary Tract Infection in Multicenter Surveillance. Infection Control and Hospital Epidemiology 29:4, 327-332
CrossRef50
Michael Gavino, Eileen Wang. (2007) A comparison of a new rapid real-time polymerase chain reaction system to traditional culture in determining group B streptococcus colonization. American Journal of Obstetrics and Gynecology 197:4, 388.e1-388.e4
CrossRef51
Andreas Herbst, Karin Källén. (2007) Time Between Membrane Rupture and Delivery and Septicemia in Term Neonates. Obstetrics & Gynecology 110:3, 612-618
CrossRef52
Tiffany S. Glasgow, Mori Speakman, Sean Firth, Brent James, Carrie L. Byington, Paul C. Young. (2007) Clinical and economic outcomes for term infants associated with increasing administration of antibiotics to their mothers. Paediatric and Perinatal Epidemiology 21:4, 338-346
CrossRef53
Andrew Kotaska. (2007) IN THE LITERATURE:Combating Coercion: Breech Birth, Parturient Choice, and the Evolution of Evidence-Based Maternity Care. Birth 34:2, 176-180
CrossRef54
P HEATH, A SCHUCHAT. (2007) Perinatal group B streptococcal disease. Best Practice & Research Clinical Obstetrics & Gynaecology 21:3, 411-424
CrossRef55
Davide Lijoi, Elisa Di Capua, Simone Ferrero, Emanuela Mistrangelo, Alessandro Giannattasio, Sandra Morano, Nicola Ragni. (2007) The efficacy of 2002 CDC guidelines in preventing perinatal group B Streptococcal vertical transmission: a prospective study. Archives of Gynecology and Obstetrics 275:5, 373-379
CrossRef56
Tim Colbourn, Ruth Gilbert. (2007) An overview of the natural history of early onset group B streptococcal disease in the UK. Early Human Development 83:3, 149-156
CrossRef57
Robert S. Baltimore. (2007) Consequences of Prophylaxis for Group B Streptococcal Infections of the Neonate. Seminars in Perinatology 31:1, 33-38
CrossRef58
Louisa Castrodale, Bradford Gessner, Laura Hammitt, Marc-Andre Chimonas, Thomas Hennessy. (2007) Invasive Early-Onset Neonatal Group B Streptococcal Cases – Alaska, 2000–2004. Maternal and Child Health Journal 11:1, 91-95
CrossRef59
William J Ledger. (2006) Prophylactic antibiotics in obstetrics–gynecology: a current asset, a future liability?. Expert Review of Anti-infective Therapy 4:6, 957-964
CrossRef60
S Håkansson, K Källén. (2006) Impact and risk factors for early-onset group B streptococcal morbidity: analysis of a national, population-based cohort in Sweden 1997-2001. BJOG: An International Journal of Obstetrics & Gynaecology 113:12, 1452-1458
CrossRef61
Atul Kumar Johri, Lawrence C Paoletti, Philippe Glaser, Meenakshi Dua, Puja Kumari Sharma, Guido Grandi, Rino Rappuoli. (2006) Group B Streptococcus: global incidence and vaccine development. Nature Reviews Microbiology 4:12, 932-942
CrossRef62
Stephanie J. Schrag, Barbara J. Stoll. (2006) Early-Onset Neonatal Sepsis in the Era of Widespread Intrapartum Chemoprophylaxis. The Pediatric Infectious Disease Journal 25:10, 939-940
CrossRef63
Kristin L. Atkins, Robyn M. Atkinson, Anthony Shanks, Curtis A. Parvin, W Michael Dunne, Gilad Gross. (2006) Evaluation of Polymerase Chain Reaction for Group B Streptococcus Detection Using an Improved Culture Method. Obstetrics & Gynecology 108:3, Part 1, 488-491
CrossRef64
San Patten, Ardene Robinson Vollman, Shannon D. Manning, Melissa Mucenski, Jeanne Vidakovich, H. Dele Davies. (2006) Vaccination for Group B Streptococcus during pregnancy: Attitudes and concerns of women and health care providers. Social Science & Medicine 63:2, 347-358
CrossRef65
AR Bedford Russell, SH Murch. (2006) Could peripartum antibiotics have delayed health consequences for the infant?. BJOG: An International Journal of Obstetrics and Gynaecology 113:7, 758-765
CrossRef66
C Mary Healy, Carol J Baker. (2006) Prospects for prevention of childhood infections by maternal immunization. Current Opinion in Infectious Diseases 19:3, 271-276
CrossRef67
Marie-Cécile Lamy, Shaynoor Dramsi, Annick Billoët, Hélène Réglier-Poupet, Asmaa Tazi, Josette Raymond, François Guérin, Elisabeth Couvé, Frank Kunst, Philippe Glaser, Patrick Trieu-Cuot, Claire Poyart. (2006) Rapid detection of the “highly virulent” group B streptococcus ST-17 clone. Microbes and Infection 8:7, 1714-1722
CrossRef68
Kate MCILWAINE, Kim KNEEBONE, Andrea BARKEHALL-THOMAS, Euan M. WALLACE. (2006) Compliance with a risk factor-based intrapartum prophylaxis program for neonatal group B streptococcal disease. The Australian and New Zealand Journal of Obstetrics and Gynaecology 46:3, 199-201
CrossRef69
Milen Peev, Sandy Cadichon, Deepa Ranganathan, Patricia Farber, Mahmoud Ismail, Sue Boonlayangoor, William Meadow. (2006) Strep and the city: Unexpected persistence of early-onset GBS sepsis despite increased intra-partum antibiotic prophylaxis in an urban university hospital. International Congress Series 1289, 62-65
CrossRef70
H Wolf, MGAJ Wouters, M Trijbels-Smeulders. (2006) Re: Cost-effectiveness of different treatment strategies with intrapartum antibiotic prophylaxis to prevent early-onset group B streptococcal disease. BJOG: An International Journal of Obstetrics and Gynaecology 113:3, 357-359
CrossRef71
Peter Y. Chen, Frank A. Vicini, Pamela Benitez, Larry L. Kestin, Michelle Wallace, Christina Mitchell, Jane Pettinga, Alvaro A. Martinez. (2006) Long-term cosmetic results and toxicity after accelerated partial-breast irradiation. Cancer 106:5, 991-999
CrossRef72
Regina M. Renner, A. Renner, Seraina Schmid, Irene Hoesli, Per Nars, Wolfgang Holzgreve, Daniel V. Surbek. (2006) Efficacy of a strategy to prevent neonatal early-onset group B streptococcal (GBS) sepsis. Journal of Perinatal Medicine 34:1, 32-38
CrossRef73
Morven S. Edwards, Victor Nizet, Carol J. Baker. 2006. Group B Streptococcal Infections. , 403-464.
CrossRef74
Lubna Chohan, Lisa M. Hollier, Karen Bishop, Charles C. Kilpatrick. (2006) Patterns of Antibiotic Resistance Among Group B Streptococcus Isolates: 2001–2004. Infectious Diseases in Obstetrics & Gynecology 2006, 1-5
CrossRef75
K. L. Chan, K. Levi, K. J. Towner, V. C. Weston, M. M. Ramsay, L. H. Kean. (2006) Evaluation of the sensitivity of a rapid polymerase chain reaction for detection of group B streptococcus. Journal of Obstetrics & Gynaecology 26:5, 402-406
CrossRef76
Lisa M. Korst, Moshe Fridman, Philippe S. Friedlich, Michael C. Lu, Carolina Reyes, Calvin J. Hobel, Gilberto F. Chavez, Kimberly D. Gregory. (2005) Hospital Rates of Maternal and Neonatal Infection in a Low-Risk Population. Maternal and Child Health Journal 9:3, 307-316
CrossRef77
Barbara J. Stoll, Nellie I. Hansen, Rosemary D. Higgins, Avroy A. Fanaroff, Shahnaz Duara, Ronald Goldberg, Abbot Laptook, Michelle Walsh, William Oh, Ellen Hale. (2005) Very Low Birth Weight Preterm Infants With Early Onset Neonatal Sepsis. The Pediatric Infectious Disease Journal 24:7, 635-639
CrossRef78
M.E. Akker-van Marle, M.E.B. Rijnders, P. Dommelen, M. Fekkes, J.P. Wouwe, M.P. Amelink-Verburg, P.H. Verkerk. (2005) Cost-effectiveness of different treatment strategies with intrapartum antibiotic prophylaxis to prevent early-onset group B streptococcal disease. BJOG: An International Journal of Obstetrics and Gynaecology 112:6, 820-826
CrossRef79
Michael T. Brady. (2005) Health care–associated infections in the neonatal intensive care unit. American Journal of Infection Control 33:5, 268-275
CrossRef80
Esther Eisenberg, Allen S. Craig, Shiva Gautam, Marwa M. Khalil, Bashar Shaktour, William Schaffner, Marie R. Griffin. (2005) Beyond Screening. The Pediatric Infectious Disease Journal 24:6, 520-524
CrossRef81
R.E. Gilbert, K. Pike, S.L. Kenyon, W. Tarnow-Mordi, D.J. Taylor. (2005) The effect of prepartum antibiotics on the type of neonatal bacteraemia: insights from the MRC ORACLE trials. BJOG: An International Journal of Obstetrics and Gynaecology 112:6, 830-832
CrossRef82
H. Réglier-Poupet, G. Quesne, E. Théo, M. Dommergues, P. Berche, P. Trieu-Cuot, C. Poyart. (2005) Prospective evaluation of a real-time PCR assay for detection of group B streptococci in vaginal swabs from pregnant women. European Journal of Clinical Microbiology & Infectious Diseases 24:5, 355-357
CrossRef83
David D. Kim, Sarah M. Page, David S. McKenna, Catherine M. Kim. (2005) Neonatal Group B Streptococcus Sepsis After Negative Screen in a Patient Taking Oral Antibiotics. Obstetrics & Gynecology 105:Supplement, 1259-1261
CrossRef84
F GUERREROGARCIA, I RODRIGUEZBRAVO, R VAZQUEZMOLINA. (2005) Mujer embarazada de 16 semanas con urocultivo positivo para Streptococcus del grupo B o Streptococcus agalactiae. Atención Primaria 35:9, 489-491
CrossRef85
Paul T Heath, Robert G Feldman. (2005) Vaccination against Group B streptococcus. Expert Review of Vaccines 4:2, 207-218
CrossRef86
Gary Sutkin, Marijane A. Krohn, R Phillips Heine, Richard L. Sweet. (2005) Antibiotic Prophylaxis and Non–Group B Streptococcal Neonatal Sepsis. Obstetrics & Gynecology 105:3, 581-586
CrossRef87
Lisa M. Korst, Jeffrey A. Gornbein, Kimberly D. Gregory. (2005) Rethinking the Cesarean Rate. Medical Care 43:3, 237-245
CrossRef88
Hyagriv N. Simhan, Timothy P. Canavan. (2005) Preterm premature rupture of membranes: diagnosis, evaluation and management strategies. BJOG: An International Journal of Obstetrics & Gynaecology 112, 32-37
CrossRef89
Nancy C. Rauen, Elizabeth M. Wesenberg, Charles P. Cartwright. (2005) Comparison of selective and nonselective enrichment broth media for the detection of vaginal and anorectal colonization with group B streptococcus. Diagnostic Microbiology and Infectious Disease 51:1, 9-12
CrossRef90
Bassel Abd El Malek, Nicholas D Embleton, Andrew D Loughney. (2005) Group B streptococcal disease: screening and treatment in pregnancy. The Obstetrician & Gynaecologist 7:1, 34-39
CrossRef91
AJ Daley, SM Garland. (2004) Prevention of neonatal group B streptococcal disease: Progress, challenges and dilemmas. Journal of Paediatrics and Child Health 40:12, 664-668
CrossRef92
Ronald S. Gibbs, Stephanie Schrag, Anne Schuchat. (2004) Perinatal Infections Due to Group B Streptococci. Obstetrics & Gynecology 104:5, Part 1, 1062-1076
CrossRef93
Regina LS Ungerer, Ornella Lincetto, William McGuire, Haroon H Saloojee, A Metin Gülmezoglu, Regina LS Ungerer. 2004. Prophylactic versus selective antibiotics for term newborn infants of mothers with risk factors for neonatal infection. .
CrossRef94
H. D. Davies, M. A. Miller, S. Faro, D. Gregson, S. C. Kehl, J. A. Jordan. (2004) Multicenter Study of a Rapid Molecular-Based Assay for the Diagnosis of Group B Streptococcus Colonization in Pregnant Women. Clinical Infectious Diseases 39:8, 1129-1135
CrossRef95
S. J. Schrag. (2004) The Past and Future of Perinatal Group B Streptococcal Disease Prevention. Clinical Infectious Diseases 39:8, 1136-1138
CrossRef96
Timothy P. Canavan, Hyagriv N. Simhan, Steve Caritis. (2004) An Evidence-Based Approach to the Evaluation and Treatment of Premature Rupture of Membranes: Part II. Obstetrical & Gynecological Survey 59:9, 678-689
CrossRef97
GL Gilbert. (2004) Vaccines for other neonatal infections: Are group B streptococcal infections vaccine-preventable?. Expert Review of Vaccines 3:4, 371-374
CrossRef98
S. D. Manning, K. Neighbors, P. A. Tallman, B. Gillespie, C. F. Marrs, S. M. Borchardt, C. J. Baker, M. D. Pearlman, B. Foxman. (2004) Prevalence of Group B Streptococcus Colonization and Potential for Transmission by Casual Contact in Healthy Young Men and Women. Clinical Infectious Diseases 39:3, 380-388
CrossRef99
Stephanie JONES, Eugene ATHAN, John VIGGERS. (2004) Prevention of recurrent fetal death in utero due to group B streptococcal chorioamnionitis. The Australian and New Zealand Journal of Obstetrics and Gynaecology 44:4, 356-357
CrossRef100
Reinhard Berner. (2004) Significance, management and prevention of Streptococcus agalactiae infection during the perinatal period. Expert Review of Anti-infective Therapy 2:3, 427-437
CrossRef101
Esse N Menson, Ruth E Gilbert, Mike R Sharland. (2004) What is the effect of prepartum antimicrobials on neonatal infection?. Current Opinion in Infectious Diseases 17:3, 213-216
CrossRef102
S. J. Schrag, A. Schuchat. (2004) Easing the Burden: Characterizing the Disease Burden of Neonatal Group B Streptococcal Disease to Motivate Prevention. Clinical Infectious Diseases 38:9, 1209-1211
CrossRef103
Sara Kenyon, Peter Brocklehurst, Ann Blackburn, David J. Taylor. (2004) Antenatal screening and intrapartum management of Group B Streptococcus in the UK. BJOG: An International Journal of Obstetrics and Gynaecology 111:3, 226-230
CrossRef104
Monique A. J. M. Trijbels-Smeulders, Louis A. A. Kollée, Albert H. Adriaanse, Jan L. L. Kimpen, Leo J. Gerards. (2004) Neonatal group B streptococcal infection: incidence and strategies for prevention in Europe. The Pediatric Infectious Disease Journal 23:2, 172-173
CrossRef105
Anne Schuchat. (2003) IMPACT OF INTRAPARTUM CHEMOPROPHYLAXIS ON NEONATAL SEPSIS. The Pediatric Infectious Disease Journal 22:12, 1087-1088
CrossRef106
Stephen Lockhart. (2003) Conjugate vaccines. Expert Review of Vaccines 2:5, 633-648
CrossRef107
Karen Cowgill, Thomas H. Taylor, Anne Schuchat, Stephanie Schrag. (2003) Report from the CDC. Awareness of Perinatal Group B Streptococcal Infection among Women of Childbearing Age in the United States, 1999 and 2002. Journal of Women's Health 12:6, 527-532
CrossRef108
Fiona Mary Russell, Jim Buttery. (2003) Vaccine development for capsulate bacteria causing pneumonia. Current Opinion in Pulmonary Medicine 9:3, 227-232
CrossRef109
MARY C. OTTOLINI, KATHLEEN LUNDGREN, LAURA J. MIRKINSON, SHEILA CASON, MARTIN G. OTTOLINI. (2003) Utility of complete blood count and blood culture screening to diagnose neonatal sepsis in the asymptomatic at risk newborn. The Pediatric Infectious Disease Journal 22:5, 430-434
CrossRef110
Nicole Winn, Kathie Records, Michael Rice. (2003) The Relationship Between Abuse, Sexually Transmitted Diseases, & Group B Streptococcus in Childbearing Women. MCN, The American Journal of Maternal/Child Nursing 28:2, 106-110
CrossRef111
Julie S. Platt, William F. O’Brien. (2003) Group B Streptococcus: Prevention of Early-Onset Neonatal Sepsis. Obstetrical & Gynecological Survey 58:3, 191-196
CrossRef112
Rodney K. Edwards, Whitney E. Jamie, Donald Sterner, Susan Gentry, Kathy Counts, Patrick Duff. (2003) Intrapartum Antibiotic Prophylaxis and Early-Onset Neonatal Sepsis Patterns. Infectious Diseases in Obstetrics & Gynecology 11:4, 221-226
CrossRef113
Monique AJM Trijbels-Smeulders, Albert H Adriaanse, Leo J Gerards, Jan LL Kimpen. (2003) Strategy to prevent neonatal early-onset group B streptococcal (GBS) disease in the Netherlands. Reviews in Medical Microbiology 14:1, 35-39
CrossRef114
(2002) Prevention of Early-Onset Group B Streptococcal Disease in Neonates. New England Journal of Medicine 347:22, 1798-1799
Full Text115
Eschenbach, David A., . (2002) Prevention of Neonatal Group B Streptococcal Infection. New England Journal of Medicine 347:4, 280-281
Full Text
- Letters
