While waiting for a vaccine: opportunities for optimization of neonatal group B streptococcal (GBS) disease prevention in Israel

J Perinatol. 2019 Feb;39(2):331-338. doi: 10.1038/s41372-018-0289-2. Epub 2018 Dec 11.

Abstract

Objective: To quantify effects of different strategies for decreasing neonatal early onset GBS sepsis (EOGBS) in Israel.

Study design: A risk allocation model for EOGBS among infants ≥ 35w was adapted to Israeli data. Effects of strategies for antepartum (APS) and intrapartum (IPS) screening, and intrapartum (IAP) and/or postpartum antibiotic prophylaxis (PAP) were calculated.

Results: Estimated EOGBS attack rates (AR) with APS in 90%, IAP in 90%, may reduce AR to 0.18/1000. A rapid intrapartum test would further decrease AR to 0.16/1000, while reducing IAP from 21.3 to 12.5% of women. For babies with risk factors and GBS+ who do not receive IAP, further risk reduction could be achieved by PAP.

Conclusion: IAP remains the main intervention to decrease EOGBS. IAP and PAP together may reduce EOGBS present incidence by 40%. Combining rapid intrapartum screening with selective IAP and selective PAP for remaining gaps, would be the most efficient strategy.

MeSH terms

  • Antibiotic Prophylaxis / statistics & numerical data*
  • Female
  • Humans
  • Incidence
  • Infant, Newborn
  • Infectious Disease Transmission, Vertical
  • Israel / epidemiology
  • Pregnancy
  • Pregnancy Complications, Infectious / prevention & control*
  • Risk Factors
  • Risk Reduction Behavior
  • Streptococcal Infections / prevention & control*
  • Streptococcus agalactiae / classification
  • Streptococcus agalactiae / isolation & purification*
  • Vaccines

Substances

  • Vaccines