Prevent Group B Strep

Tool for Neonatal Providers

Photo: Baby in the neonatalEnter the infant’s clinical appearance and other risk factors. Move through this tool to create customized recommendations for neonatal care.
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Prevent Group B Strep

Terms of use

The User acknowledges and agrees that this tool will be used only as a reference aid, and that the information contained in the product is not intended to be (nor should it be used as) a substitute for the exercise of professional judgment.

In view of the possibility of human error or changes in medical science, the User should confirm the information in the product conforms to the current version of the CDC GBS guidelines by checking for guideline updates. This product is provided without warranties of any kind, express or implied, and the authors disclaim any liability, loss, or damage caused by it or its content.

By indicating ‘I agree’ below, you have indicated your acceptance of these terms.

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Prevent Group B Strep

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Does the newborn have signs and/or symptoms of neonatal sepsis?
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Prevent Group B Strep

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Was the newborn’s mother diagnosed with chorioamnionitis? More Info.. Hide
Consultation with obstetric providers is important to determine the level of clinical suspicion for chorioamnionitis. Chorioamnionitis is diagnosed clinically and some of the signs are nonspecific.
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Prevent Group B Strep

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Was GBS prophylaxis indicated for the mother? More Info.. Hide

Intrapartum GBS prophylaxis
indicated

  • Previous infant with invasive GBS disease
  • GBS bacteriuria during any trimester of the current pregnancy
  • Positive GBS vaginal-rectal screening culture in late gestation during current pregnancy
  • Unknown GBS status at the onset of labor (culture not done, incomplete, or results unknown) and any of the following:
    • Delivery at <37 weeks' gestation
    • Amniotic membrane rupture ≥18 hours
    • Intrapartum temperature ≥100.4°F (≥38.0°C)
    • Intrapartum nucleic acid amplification test (e.g. PCR) positive for GBS

Intrapartum GBS prophylaxis
not indicated

  • Colonization with GBS during a previous pregnancy (unless an indication for GBS prophylaxis is present for current pregnancy)
  • GBS bacteriuria during previous pregnancy (unless an indication for GBS prophylaxis is present for current pregnancy)
  • Negative vaginal and rectal GBS screening culture in late gestation during the current pregnancy, regardless of intrapartum risk factors
  • Cesarean delivery performed before onset of labor on a woman with intact amniotic membranes, regardless of GBS colonization status or gestational age

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Prevent Group B Strep

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Did the newborn’s mother receive intravenous penicillin, ampicillin, or cefazolin ≥4 hours before delivery?
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Prevent Group B Strep

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Is the newborn’s gestational age ≥37 weeks (i.e. full term)?
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Prevent Group B Strep

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Have antibiotic membranes been ruptured ≥18 hours?
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Prevent Group B Strep

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Patient Characteristics

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Prevent Group B Strep

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Patient Characteristics

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Prevent Group B Strep

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Patient Characteristics

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Prevent Group B Strep

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Patient Characteristics

Limited Evaluation

  • Blood culture (at birth)
  • Complete blood count (CBC), including white cell differential and platelet counts (at birth and/or at 6-12 hours of life)


Observe in hospital
for ≥ 48 hours

* If ANY signs or symptoms of sepsis develop, antibiotic therapy should be initiated and a full diagnostic evaluation, consisting of: a blood culture, complete blood count (CBC), including white cell differential and platelet count, a chest radiograph (if respiratory abnormalities are present), and a lumbar puncture (if patient is stable enough to tolerate procedure) should be conducted.

Antibiotic therapy should be directed toward most common causes of neonatal sepsis, including ampicillin for GBS and coverage for other organisms (including Escherichia coli and other gram-negative pathogens) should take into account local antibiotic resistance patterns.

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