[Prevention of early-onset group B Streptococcus infections. 2. Efficiency of the ANAES guidelines]

Abstract

Objectives: To examine the efficiency on early-onset neonatal infections of the ANAES guidelines for early-onset infections prophylaxis, based on a systematic prenatal vaginal swab aiming Group B Streptococcus and/or infection risk factors during delivery.

Patients and methods: This is a retrospective cohort study of early-onset infections during a period of 28 months (6125 deliveries) compared to an earlier period (6141 deliveries).

Results: The number of newborns admitted for suspected infection and the rate of sepsis have been unchanged. But the total number of infections has decreased (1.50 vs 2.02 %, p=0,024), without increase of the number of infections due to other germs such as Escherichia coli. Furthermore, a strategy based only on risk factors would not have allowed the early screening and treatment of 23 Streptococcus B infected newborns.

Conclusion: We have proved the efficiency of the protocol in terms of prevention of early-onset infections. However, it has led to a dramatic increase in the consumption of antibiotics, which is worrying concerning maternal and neonatal bacterial ecology.