Group B Streptococcus Infection

Maternal transmission of group B Streptococcus during the intrapartum period is a cause of neonatal sepsis and death. All pregnant women should be screened for group B Streptococcus disease using vaginal and rectal swabs between 35 and 37 weeks of gestation. Antibiotic therapy has been proven to reduce the incidence of early-onset neonatal group B Streptococcus infection when administered to high-risk groups of women. Empirical treatment should be started for group B Streptococcus at the time of membrane rupture and continued until delivery (Table 47-8). The antibiotic of choice for group B streptococcal disease is penicillin G, although ampicillin, erythromycin, or clindamycin are good alternatives.41 Resistance has developed with the use of some alternative choices for penicillin-allergic patients.

The neonate should be observed for signs and symptoms of sepsis until 48 hours after birth. If present, a full diagnostic workup (including complete blood cell count and blood culture) should be initiated and empirical antibiotic therapy started.41

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