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Strategies for Preventing Neonatal Group B Streptococcal Disease

Published online by Cambridge University Press:  02 January 2015

Donald A. Goldmann
Donald A. Goldmann*
Affiliation:
Infection Control Program and Division of Infectious Diseases, Children's Hospital, and the Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
*
Division of infectious Diseases, Children's Hospital, 300 Longwood Avenue, Boston, MA 02115
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Extract

Despite increased awareness and the availability of potent chemotherapeutic agents, the Group B streptococcus remains the leading cause of life-threatening bacterial infections in the neonatal period. The majority of infections occur in the first few days of life. These so-called “early-onset” infections are often fulminant and are associated with a very high case fatality rate, ranging from more than 20% in recent reports to as high as 80% in older series. “Late-onset” disease occurs, by definition, after the first week of life. It usually presents with meningitis, although a wide spectrum of infections has been reported, including cellulitis, adenitis, septic arthritis, and osteomyelitis. Late-onset disease is usually less serious than early-onset disease, although deaths do occur and major sequelae are not rare. Accordingly, attempts to prevent group B streptococcal infections have concentrated on the more common and frequently lethal early-onset disease. Strategies that have been considered to date include antibiotic- and immuno-prophylaxis. In the preceding article, Easmon advocates an additional approach; topical use of the antiseptic Chlorhexidine gluconate in the vagina during labor.

Type
Research Article
Information
Infection Control & Hospital Epidemiology , Volume 7 , supplement S2: Proceedings of the Second ICI/Stuart Workshop , February 1986 , pp. 137 - 143
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1986

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