Group B streptococcal colonisation of mother

DO NOT USE FOR CLINICAL PRACTICE
Please use current guidelines available on the UHNM intranet for patient treatment

Based on RCOG Green Top Guideline No. 36 2017 update

BACKGROUND

Mortality from Group B streptococcal (GBS) infection:
- term: 2–3%
- preterm: 20–30%
Baby infected with GBS has a 1 in 19 risk of dying and 1 in 14 survivors will have long-term disability
90% of babies with early onset GBS infection are symptomatic within 12 hr of birth
A mother colonised with GBS during pregnancy has a 50% risk of colonisation in subsequent pregnancies
Colonised mother who had a previous baby affected by GBS has a greater chance of having another affected baby, than a colonised mother who has not had an affected baby
Intrapartum antibiotic prophylaxis (IAP) does not prevent late onset GBS infection

Offer IAP to:
- mother identified as colonised with GBS during pregnancy
  - any growth of GBS is significant (urine, rectum or vagina), whether identified accidentally/routinely
- mother with previous affected baby
- preterm labour (including without known GBS colonisation)
IAP not required for planned delivery by caesarean section with intact membranes and in the absence of labour

No action required for term baby whose mother received IAP >4 hr before delivery
If IAP was indicated but not given/declined or if delivery was within 4 hr of first dose of IPA:
- baby to be reviewed for signs of infection
- neonatal observations at 0, 1, and 2 hr and then 2-hrly until 12 hr
- early discharge (within 24 hr of birth) to be avoided
- RCOG does NOT recommend blood culture and/or antibiotic prophylaxis
If baby appears unwell follow Infection in first 72 hours of life guideline)