Missed opportunities for preventing GBS infections

Stefania Vergnano ^1*, Nick D Embleton ², Andrew Collinson ³, Esse Menson ⁴, Alison R Bedford Russell ⁵ and Paul T Heath ¹

¹ St George's, University of London, United Kingdom
² Newcastle Neonatal Service Royal Victoria Infirmary Newcastle Upon Tyne, United Kingdom
³ Royal Devon and Exeter NHS Foundation Trust, United Kingdom
⁴ The Evlina Children's Hospital, London, United Kingdom
⁵ Heart of England NHS Trust, Birmingham, United Kingdom

^* To whom correspondence should be addressed. E-mail: s.vergnano{at}ich.ucl.ac.uk.

Accepted 30 April 2009

Abstract

Background: Group B Streptococcus (GBS) is the most common cause of early onset (EO) neonatal infection in the UK. National guidelines for its prevention were introduced in 2003. We assessed the opportunities for prevention amongst cases of EO GBS using the electronic Neonatal Infection Surveillance Network (NeonIN).

Methods: Culture proven EO GBS cases occurring between 2004-7 were identified prospectively in 8 neonatal units participating in NeonIN. Data concerning risk factors, intrapartum antibiotic (IAP) use and infant outcome were collected retrospectively.

Results: There were 48 cases of GBS over the 4 years (0.52/1000 live-births); 22 male, median gestation 38 weeks. The most common clinical presentation was sepsis and the GBS-attributable mortality was 6%. Risk factors were present in 67% (32) and adequate IAP was given to 6 of these mothers (19%). If all women with risk factors received prophylaxis, 23 cases (48%) may have been prevented.

Conclusions: Better GBS prevention strategies are required in the UK.