Prevention of early-onset group B streptococcus neonatal diseases The 2005 experience of the Lille university health center

Objectives. - To study the efficiency of the official recommendations on the prevention of group B streptococcus and the impact of this strategy. Materials and methods. - A prospective study was realized in 2005. All infants who were live-born at the Jeanne-de-Flandre hospital (Lille, France) and their mothers were included in the study. Data concerned both pregnancy (vaginal screening, intrapartum antibiotic) and newborn (safe, colonization and early-onset neonatal bacterial disease). Results. - Our study included 4353 mother-newborn couples. Vaginal. screening was performed on 92% of the women included in the study. Prevalence of vaginal group B streptococcus in screened women was 7%. Perpartum antibioprophylaxia of group B streptococcus was achieved in 12% of the women included in the study. Group B streptococcus was associated to 60% of probable and certain early-onset bacterial neonatal diseases, with an incidence of 9/1000 births. Exposition to antenatal. antibiotherapy multiplied by two the risk of ampicillin resistant Gram-negative bacilli (RR = 2 [1.1-3.8]). Conclusion. - Recommendations were well followed, but in our health center group, B streptococcus was the main bacteria responsible for early-onset bacterial neonatal diseases. Because of the risk of germ selection, a more targeted antibioprophylaxia has to be preferred. (c) 2008 Elsevier Masson SAS.