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Shahad I Zoli,1 Maisa A Baiti,1 Atyaf A Alhazmi,1 Raud M Khormi,1 Maram A Sayegh,1 Tahani Altubayqi,1 Afnan M Darisi,1 Raffan A Alhasani,1 Saleha H Alhazmi,1 Sarah O Gharawi,1 Abdulrahman A Muhajir,2 Abdulaziz H Alhazmi1 1Faculty of Medicine, Jazan University, Jazan, Saudi Arabia; 2General Directorate of Health Affairs, Jazan, Saudi ArabiaCorrespondence: Abdulaziz H Alhazmi, Tel +966-7-3295000, Email abalhazmi@jazanu.edu.saBackground: Group B streptococcus (GBS) infection is one of the leading causes of neonatal sepsis and meningitis. GBS screening and intrapartum antibiotic prophylaxis can effectively prevent early-onset GBS disease. This study aimed to assess the awareness of the risks of GBS infection and screening in Jazan Province, Saudi Arabia.Methodology: A cross-sectional study was conducted using a survey of 995 women aged 18– 45 in Jazan, Saudi Arabia. Data were collected between January to April 2023 and included information on sociodemographic characteristics, awareness of GBS infection, and perspectives on GBS screening.Results: The response rate was 97.45%, and the mean age of the participants was 31.50 ± 9.80 years. Most were married (60.2%), had a university education (81.11%), and 59% were pregnant or had a pregnancy history. Only 23% had heard of GBS, associated with age, marital status, job, pregnancy status, awareness of GBS risk factors, and pregnancy follow-up (p < 0.05). Women most aware were students (55.9%), married (55.46%), pregnant or had a pregnancy history (51.09%), knew risk factors of GBS (38.86%), and were followed by a specialist (88.14%). Regarding GBS screening preferences, 40% preferred universal screening without consent, 31% with consent, 16% for high-risk pregnancies with consent, and 13% for high-risk pregnancies without consent.Conclusion: The study found low awareness of GBS among women residing in Jazan, Saudi Arabia. Factors related to demographic details and obstetric follow-up were associated with better understanding. Most women preferred universal screening for GBS, with or without consent. Effective health education is needed to raise women’s awareness of screening benefits and risks. This education can help women make informed decisions and improve prevention and care. Future studies may evaluate healthcare providers’ awareness of GBS.Keywords: group B streptococcus, GBS screening, women’s awareness, Jazan, Saudi Arabia

Objective: Self-sampling with proper instruction in 35–37 weeks’ gestation is an option to clinician sampling to prevent early-onset invasive group B streptococcal disease of infants. We aimed to assess the accuracy of self-sampling and influencing factors of preference for collection method in Chinese women. Methods: We compared the screening results of self-sampling with clinician collection in a sample of 520 women in late pregnancy. We collected their demographics, clinical information and preference for collection method. A multi-nominal logistic regression model was used to measure the association between the influencing factors and these participants’ preference. Results: A good agreement between the two collection methods was found with a Cohen’s Kappa coefficient 0.83 (95%CI = 0.71–0.95). The prevalence of GBS infection in the two methods is statistically different in this low-risk group when self-sampling presented a better outcome in terms of detecting positive cases. Self-sampling is preferable by 20.9% of the participants. No less pain during self-sampling and age older than 35 years old was statistically related to preference for clinician collection. Conclusion: The accuracy of self-sampling is no worse than clinician collection. It could be an option for those younger than 35 years old, especially for those who report low pain threshold. Pregnant women are able to collect rectovaginal samples prior to their antenatal visit. Self-sampling followed by appropriate transportation of the sample to an advanced laboratory could eliminate the effects of local laboratory capacity. There are implications in increasing GBS screening participation in resource-limited settings. [ABSTRACT FROM AUTHOR]

Purpose: Intrapartum antibiotic prophylaxis (IAP) prevents group B streptococcus (GBS) early-onset disease (EOD). No European study evaluates the relative impact of risk factors (RFs) for EOD after a screening-based strategy and widespread IAP use We aimed to evaluate the risks of EOD in an Italian region where a screening-based strategy for preventing EOD was implemented.Materials and methods: Cases of EOD born at or above 35 weeks' gestation were reviewed and matched with controls.Results: There were 109 cases of EOD among 532,154 live births. Most cases had negative GBS prenatal screening (56/91, 61.5%) and were unexposed to IAP (86/109, 78.9%). At multivariate analysis, GBS bacteriuria (OR = 6.99), positive prenatal screening (OR = 13.7) and maternal intrapartum fever (OR = 188.3) were associated with an increased risk of EOD, whereas intrapartum beta-lactam antibiotics were associated with a decreased risk of EOD (≥4 h: OR = 0.008; <4 h: OR = 0.04). Neonates born to nonfebrile, GBS positive pregnant women, receiving beta-lactam antibiotics had very low probability of EOD, particularly if IAP was adequate.Conclusions: GBS positive prenatal screening, GBS bacteriuria and intrapartum fever are associated with EOD. Intrapartum beta-lactam antibiotics reduce the probability of EOD in neonates born to nonfebrile mothers. [ABSTRACT FROM AUTHOR]

Group B streptococcus (GBS) remains worldwide a leading cause of severe neonatal disease. Since the end of the 1990s, various strategies for prevention of the early onset neonatal disease have been implemented and have evolved. When a universal antenatal GBS screening-based strategy is used to identify women who are given an intrapartum antimicrobial prophylaxis, a substantial reduction of incidence up to 80% has been reported in the USA as in other countries including European countries. However recommendations are still a matter of debate due to challenges and controversies on how best to identify candidates for prophylaxis and to drawbacks of intrapartum administration of antibiotics. In Europe, some countries recommend either antenatal GBS screening or risk-based strategies, or any combination, and others do not have national or any other kind of guidelines for prevention of GBS perinatal disease. Furthermore, accurate population-based data of incidence of GBS neonatal disease are not available in some countries and hamper good effectiveness evaluation of prevention strategies. To facilitate a consensus towards European guidelines for the management of pregnant women in labor and during pregnancy for the prevention of GBS perinatal disease, a conference was organized in 2013 with a group of experts in neonatology, gynecology-obstetrics and clinical microbiology coming from European representative countries. The group reviewed available data, identified areas where results were suboptimal, where revised procedures and new technologies could improve current practices for prevention of perinatal GBS disease. The key decision issued after the conference is to recommend intrapartum antimicrobial prophylaxis based on a universal intrapartum GBS screening strategy using a rapid real time testing. [ABSTRACT FROM AUTHOR]

Early onset neonatal group B streptococcal (GBS) sepsis is a serious neonatal illness with high morbidity and mortality. The disease can present in two forms: early clinical manifestation with respiratory distress soon after birth or late presentation with gradual onset of signs of sepsis. The former carries a high risk for serious cardiovascular complication with persistent pulmonary hypertension; the latter is often complicated with meningitis that may lead to serious neurodevelopmental impairment. An important advance in the past three decades is the development and implementation of preventive strategy for this disease by universal screening and identification of maternal GBS carriers and/or risk factors with subsequent use of intrapartum antibiotic prophylaxis. The strategy has resulted in a significant reduction of the disease from 1.5 to 0.3/ 1,000 live births over the past three decades. Some women may have unknown GBS status. The American Academy of Pediatrics has developed an algorithm as guidance for the management of the newborns. [ABSTRACT FROM AUTHOR]

The objective of this article is to determine whether racial/ethnic disparities exist in screening for group B streptococcus (GBS) colonization among pregnant women. A retrospective cohort study of deliveries at a single institution was conducted. The primary outcome was the availability of GBS culture data at the time of delivery; the primary predictor was maternal race/ethnicity. Analyses were stratified by the time periods before and after the CDC recommendations for universal screening for GBS. Among 16,333 deliveries, 60.4% of the population was screened for GBS but screening rates varied markedly by year of delivery. Black women had a lower odds of having available GBS data (AOR 0.81 [0.69, 0.95]) but this disparity was limited to the period of time before universal screening was recommended. Prior to the recommendation for universal screening for GBS, racial/ethnic disparities existed in rates of screening among pregnant women delivering at term. These differences were reduced after 2002, suggesting that uniform policies regarding obstetrical care may be effective in eliminating disparities in obstetrical care and outcomes. [ABSTRACT FROM AUTHOR]

ObjectiveThe objective of the study was to determine the rate of early onset group B streptococcus (EOGBS) infection in Utah and identify potential areas of failure in EOGBS prevention.Study DesignWe queried the microbiology records of Intermountain Healthcare for infants with culture-confirmed EOGBS between 1 January 2002 and 31 May 2006 and calculated rates of EOGBS per 1000 deliveries. We reviewed the infant and maternal records of each EOGBS case to identify possible failures in EOGBS prevention.ResultThere were 54 cases of EOGBS among the 127 205 births (0.42/1000 births). Of all, 12 were preterm. Of the 39 (93%) women prenatally screened for GBS, 31 (79%) had negative results and 7/8 (88%) women with positive prenatal GBS screens either did not receive intrapartum antibiotic prophylaxis (IAP) or received inadequate IAP. Of the 54 infants with EOGBS, 3 (6%) died.ConclusionUtah's rates of EOGBS were higher than the national average. Factors associated with EOGBS include missed screening opportunities, inadequate IAP, and false-negative maternal GBS culture.Journal of Perinatology (2009) 29, 20–25; doi:10.1038/jp.2008.115; published online 14 August 2008 [ABSTRACT FROM AUTHOR]

Aim: To determine the effect of institution of a universal screening protocol as per CDC 2002 guidelines had on the incidence of early-onset Group B streptococcal (GBS) and non-GBS disease in a tertiary obstetric unit. Methods: A prospective study with historical control data reporting the incidence of early-onset GBS and non-GBS disease following institution of a universal screening strategy at John Hunter Hospital, Newcastle, Australia. We compared the incidence of early-onset GBS and non-GBS disease during prescreening (1994–2002) with screening period (2004 to June 2006). The outcome measure was the incidence of early-onset GBS disease. We specifically reported the number of women needed to treat (NNT) with antibiotics and the number of women needed to screen. Results: The incidence of early-onset GBS and non-GBS during the prescreening period was 0.84/1000 and 0.94/1000 live births, respectively. After institution of universal screening, the incidence was 0.00/1000 and 0.72/1000 live births, respectively. This is a statistically significant reduction in early-onset GBS disease by 84% (χ 2 = 5.75; P = 0.016). There was no difference in non-GBS disease (χ 2 = 0.14; P = 0.71). The NNT is 1191 and we needed to screen 5704 women to prevent one case of early-onset GBS disease. Conclusion: Screening for GBS rather than by assessing risk factors has significantly reduced the incidence of early-onset GBS disease in our unit. Despite low incidence of early-onset GBS prior to screening period, we still found a significant decrease in early-onset GBS disease after institution of universal screening protocol. These results support the screening-based approach at 34–37 weeks gestation. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the usefulness of universal culture-based GBS screening at 35-37 weeks of gestation, assess the efficacy of intrapartum antibiotic administration (IAP) and investigate factors influencing the infection rate in neonates. Methods: Out of 1653 pregnant women 304 (18.4%) further analyzed were GBS positive directly before the delivery, among them 69 were false GBS negative on antenatal screening. Various variables regarding parturients' and newborns' characteristics were taken into account in order to achieve the objective of the study. Results: Out of 304 GBS-positive patients directly before the delivery, culture-based screening was positive in 72.4%, while 22.7% presented with GBS-negative screening and received no IAP. No single culture-confirmed early-onset GBS disease was observed. Conclusions: IAP is an effective way of early-onset GBS disease prevention, however prenatal screening would be most efficient if performed intrapartal. [ABSTRACT FROM AUTHOR]

It has been previously well defined that selective vagino-anorectal culture is required for detection of group B streptococcal (GBS) carriage. We interestingly observed that in 5.74% of carriers, GBS were recovered only from cervico-vaginal samples inoculated onto nonselective human blood agar, without recovery from vagino-anorectal samples inoculated to four selective media. [Copyright &y& Elsevier]