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PER/TUE/01 EARLY-ONSET GROUP B STREPTOCOCCUS: AUDIT OF PREVENTION OPPORTUNITIES USING NEONIN
1S Vergnano, 2E Menson, 1P Heath. 1St George’s, University of London, London, UK; 2Evelina Children’s Hospital, London, UK
Aims: Group B streptococcus (GBS) is the most common cause of early-onset neonatal sepsis in the United Kingdom. The national incidence of early-onset GBS disease was 0.48 per 1000 live births in 2001. In November 2003 the Royal College of Obstetricians and Gynaecologists (RCOG) launched national guidelines for the prevention of early-onset GBS. The guidelines recommend intrapartum antibiotic prophylaxis (IAP) in the presence of certain risk factors. Cases of culture-confirmed GBS disease reported to the Neonatal Infection Surveillance Network (NeonIN) database were reviewed to establish compliance with these guidelines.
Methods: Culture-confirmed early-onset GBS cases were identified through the NeonIN database. This collects longitudinal data on culture-confirmed infections in newborns across a number of UK neonatal units. For all cases identified, a questionnaire regarding maternal risk factors listed in the 2003 guidelines, antibiotic prophylaxis use and infant outcome was completed retrospectively. All babies with culture-positive early-onset GBS disease (0–6 days) in eight participating units from 2004 to October 2007 were included. The denominator data were obtained from the units’ reports and the 2005 California Medical Association report. Data were analysed for the incidence of early-onset GBS disease, the presence of risk factors for early-onset GBS, appropriate use of IAP and clinical presentation.
Results: During the study period 42 cases of GBS were identified (incidence of early-onset GBS disease 0.52 per 1000 live births); 22 male, median birth weight 2875 g (850–4990), median gestational age 38 weeks (25–41). The most common clinical presentation was sepsis. At least one of the risk factors stated in the RCOG guidelines was present in 14/25 cases (56%) and two or more risk factors were present in 11 (44%). Only six mothers received IAP. …