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While waiting for a vaccine: opportunities for optimization of neonatal group B streptococcal (GBS) disease prevention in Israel

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Objective:To quantify effects of different strategies for decreasing neonatal early onset GBS sepsis (EOGBS) in Israel.Study design:A risk allocation model for EOGBS among infants ≥ 35w was adapted to Israeli data.… Click to show full abstract

Objective:To quantify effects of different strategies for decreasing neonatal early onset GBS sepsis (EOGBS) in Israel.Study design:A risk allocation model for EOGBS among infants ≥ 35w was adapted to Israeli data. Effects of strategies for antepartum (APS) and intrapartum (IPS) screening, and intrapartum (IAP) and/or postpartum antibiotic prophylaxis (PAP) were calculated.Results:Estimated EOGBS attack rates (AR) with APS in 90%, IAP in 90%, may reduce AR to 0.18/1000. A rapid intrapartum test would further decrease AR to 0.16/1000, while reducing IAP from 21.3 to 12.5% of women. For babies with risk factors and GBS+ who do not receive IAP, further risk reduction could be achieved by PAP.Conclusion:IAP remains the main intervention to decrease EOGBS. IAP and PAP together may reduce EOGBS present incidence by 40%. Combining rapid intrapartum screening with selective IAP and selective PAP for remaining gaps, would be the most efficient strategy.

Keywords: iap; israel; vaccine opportunities; opportunities optimization; waiting vaccine; gbs

Journal Title: Journal of Perinatology
Year Published: 2018

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