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Assessing standards for prevention of early onset group B streptococcal (GBS) disease in Ireland

BACKGROUND: Early onset group B streptococcal (GBS) disease can cause significant neonatal morbidity and mortality. There is currently no Irish national guideline for GBS screening, and protocols vary across maternity units. Polymerase chain reaction (PCR) testing at induction or labour onset inform...

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Autores principales: Dakin, Alex, Ferguson, Wendy, Drew, Richard, McCallion, Naomi, Higgins, Mary F., Eogan, Maeve
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8120250/
https://www.ncbi.nlm.nih.gov/pubmed/33988805
http://dx.doi.org/10.1007/s11845-021-02639-7
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author Dakin, Alex
Ferguson, Wendy
Drew, Richard
McCallion, Naomi
Higgins, Mary F.
Eogan, Maeve
author_facet Dakin, Alex
Ferguson, Wendy
Drew, Richard
McCallion, Naomi
Higgins, Mary F.
Eogan, Maeve
author_sort Dakin, Alex
collection PubMed
description BACKGROUND: Early onset group B streptococcal (GBS) disease can cause significant neonatal morbidity and mortality. There is currently no Irish national guideline for GBS screening, and protocols vary across maternity units. Polymerase chain reaction (PCR) testing at induction or labour onset informs triage for antibiotic prophylaxis; however, there are human and infrastructural resource requirements to enable widespread implementation. AIM: Our aim was to identify current standard practices for GBS prevention in Irish obstetric and neonatal services and to utilise this data to inform the need for, and potential impact of implementation of, a national guideline. METHODS: A questionnaire on GBS screening, management and existing resources was completed by an informed staff member from each of the 19 Irish maternity units, including questions regarding timing and method of screening, antibiotic usage, and neonatal management. RESULTS: One unit (5.2%) performs routine GBS screening at 35–37 weeks of gestation. Twelve units (63%) screen for GBS following spontaneous rupture of membranes (SROM) after 37 weeks, of which two (17%) perform PCR and ten (83%) culture testing. Seventeen units (89.3%) have access to a GeneXpert PCR machine, and of these, two (11.7%) use the machine for rapid GBS testing. Two units screen patients for GBS at either the start of labour or induction of labour. Four units (21%) use the neonatal early onset sepsis (EOS) calculator. Sixteen units (84%) do not treat asymptomatic infants born to GBS-positive mothers.  CONCLUSION: There is a lack of consistency in the methods for GBS screening and disease prevention across the country, highlighting the need for a national guideline accompanied by an implementation plan and budget to standardise care.
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spelling pubmed-81202502021-05-14 Assessing standards for prevention of early onset group B streptococcal (GBS) disease in Ireland Dakin, Alex Ferguson, Wendy Drew, Richard McCallion, Naomi Higgins, Mary F. Eogan, Maeve Ir J Med Sci Original Article BACKGROUND: Early onset group B streptococcal (GBS) disease can cause significant neonatal morbidity and mortality. There is currently no Irish national guideline for GBS screening, and protocols vary across maternity units. Polymerase chain reaction (PCR) testing at induction or labour onset informs triage for antibiotic prophylaxis; however, there are human and infrastructural resource requirements to enable widespread implementation. AIM: Our aim was to identify current standard practices for GBS prevention in Irish obstetric and neonatal services and to utilise this data to inform the need for, and potential impact of implementation of, a national guideline. METHODS: A questionnaire on GBS screening, management and existing resources was completed by an informed staff member from each of the 19 Irish maternity units, including questions regarding timing and method of screening, antibiotic usage, and neonatal management. RESULTS: One unit (5.2%) performs routine GBS screening at 35–37 weeks of gestation. Twelve units (63%) screen for GBS following spontaneous rupture of membranes (SROM) after 37 weeks, of which two (17%) perform PCR and ten (83%) culture testing. Seventeen units (89.3%) have access to a GeneXpert PCR machine, and of these, two (11.7%) use the machine for rapid GBS testing. Two units screen patients for GBS at either the start of labour or induction of labour. Four units (21%) use the neonatal early onset sepsis (EOS) calculator. Sixteen units (84%) do not treat asymptomatic infants born to GBS-positive mothers.  CONCLUSION: There is a lack of consistency in the methods for GBS screening and disease prevention across the country, highlighting the need for a national guideline accompanied by an implementation plan and budget to standardise care. Springer International Publishing 2021-05-14 2022 /pmc/articles/PMC8120250/ /pubmed/33988805 http://dx.doi.org/10.1007/s11845-021-02639-7 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Original Article
Dakin, Alex
Ferguson, Wendy
Drew, Richard
McCallion, Naomi
Higgins, Mary F.
Eogan, Maeve
Assessing standards for prevention of early onset group B streptococcal (GBS) disease in Ireland
title Assessing standards for prevention of early onset group B streptococcal (GBS) disease in Ireland
title_full Assessing standards for prevention of early onset group B streptococcal (GBS) disease in Ireland
title_fullStr Assessing standards for prevention of early onset group B streptococcal (GBS) disease in Ireland
title_full_unstemmed Assessing standards for prevention of early onset group B streptococcal (GBS) disease in Ireland
title_short Assessing standards for prevention of early onset group B streptococcal (GBS) disease in Ireland
title_sort assessing standards for prevention of early onset group b streptococcal (gbs) disease in ireland
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8120250/
https://www.ncbi.nlm.nih.gov/pubmed/33988805
http://dx.doi.org/10.1007/s11845-021-02639-7
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