The updated recommendations from the American Academy of Pediatrics (AAP) on management of infants at risk for group B streptococcal (GBS) disease support universal antenatal microbiologic-testing of pregnant women for the detection of maternal GBS colonization so that appropriate intrapartum antibiotic prophylaxis may be administered to prevent transmission of the bacteria from mother to the newborn before or during delivery as also recommended by the American College of Obstetricians and Gynecologists (ACOG).
Published online July 8, 2019 in the journal Pediatrics, the AAP recommendations for infant care include:
· Administering antibiotic during childbirth, when indicated and as recommended by the ACOG to protect the newborn from transmission of GBS.
· In evaluating the risk of GBS infection in the newborn, infants born at ≥35 0/7 weeks gestation and those born at ≤34 6/7 weeks gestation should be considered separately. Infants born at 34 6/7 weeks gestation are preterm and are at highest risk for early-onset sepsis, including Group B streptococcal disease.
· Early-onset Group B streptococcal infection should be diagnosed by blood or cerebrospinal fluid culture.
· Evaluation for late-onset Group B streptococcal disease, which is associated with preterm birth, should be based on clinical signs of illness.
· The preferred antibiotic for confirmed GBS disease in infants is penicillin G, followed by ampicillin.
A healthy pregnant woman might be colonized with no evident signs and symptoms of the illness. Group B strep infection in infants can be potentially fatal due to complications like sepsis, meningitis, or pneumonia.
Padma Shri Awardee
President Elect Confederation of Medical Associations in Asia and Oceania (CMAAO)
Group Editor-in-Chief IJCP Publications
President Heart Care Foundation of India