Neonatal infections: group B streptococcus

Abstract

Introduction: One in four women carry group B streptococci vaginally, which can infect the amniotic fluid before delivery or can infect the baby during delivery, causing sepsis, pneumonia, or meningitis. Very low-birthweight infants are at much higher risk of infection or mortality, with up to 3% infected and mortality rates of up to 30%, even with immediate antibiotic treatment. Late-onset group B streptococcal infection begins from 7 days of age, and usually causes fever or meningitis, but is less often fatal compared with early infection.

Methods and outcomes: We conducted a systematic review and aimed to answer the following clinical question: what are the effects of prophylactic treatment of asymptomatic neonates less than 7 days old with known risk factors for early-onset group B streptococcal infection? We searched: Medline, Embase, The Cochrane Library, and other important databases up to November 2013 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).

Results: We found 5 studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions.

Conclusions: In this systematic review we present information relating to the effectiveness and safety of the following interventions: different antibiotics, monitoring and selective treatment, and routine antibiotic prophylaxis.