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.
Dr KK Aggarwal
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
Past National President
IMA
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