How is neonatal sepsis prevented?

Updated: Jun 13, 2019
  • Author: Nathan S Gollehon, MD, FAAP; Chief Editor: Muhammad Aslam, MD  more...
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Answer

The American College of Obstetrics and Gynecology (ACOG) [32] and the Committee on Infectious Diseases of the American Academy of Pediatrics (AAP) [23] recommends that obstetric care include a strategy for managing early-onset group B streptoccocal (GBS) disease. Women with GBS bacteriuria should be treated during pregnancy when the condition is diagnosed and during the intrapartum period. It is also recommended that women who have previously given birth to an infant with invasive GBS disease receive antibiotic prophylaxis during labor and delivery.

Universal screening for GBS during pregnancy is now ubiquitous in the United States. The Centers for Disease Control and Prevention (CDC) created guidelines for the use of intrapartum antibiotic prophylaxis to prevent GBS infection in 1996, [62] which were subsequently updated in 2002, and 2010. [3, 25]

To minimize the risk of early-onset GBS disease, practitioners should obtain screening vaginal and rectal cultures at 35-37 weeks’ gestation in all pregnant women unless the patients have had GBS bacteriuria in the current pregnancy or have previously had a child with invasive GBS disease. Implementation of a screening protocol has led to a significant decrease in the incidence of neonatal GBS disease. [2, 3, 4] Recommendations have been formulated for antibiotic prophylaxis regimens. See the images below.

Neonatal sepsis. Indications and nonindications fo Neonatal sepsis. Indications and nonindications for intrapartum antibiotic prophylaxis to prevent early-onset group B streptococcal (GBS) disease. Table from Verani JR, McGee L, Schrag SJ, for the Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC). Prevention of perinatal group B streptococcal disease--revised guidelines from CDC, 2010. MMWR Recomm Rep. 2010 Nov 19. 59 (RR-10):1-36. Online at: https://www.cdc.gov/mmwr/preview/mmwrhtml/rr5910a1.htm.
Neonatal sepsis. Recommended regimens for intrapar Neonatal sepsis. Recommended regimens for intrapartum antibiotic prophylaxis for prevention of early-onset group B streptococcal (GBS) disease. Diagram from Verani JR, McGee L, Schrag SJ, for the Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC). Prevention of perinatal group B streptococcal disease--revised guidelines from CDC, 2010. MMWR Recomm Rep. 2010 Nov 19. 59 (RR-10):1-36. Online at: https://www.cdc.gov/mmwr/preview/mmwrhtml/rr5910a1.htm.

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