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Group B Streptococcal Sepsis

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1. Prevention of Early-Onset Group B Streptococcal Disease in Newborns

Prevention of Early-Onset Group B Streptococcal Disease in Newborns INTERIM UPDATE ACOGCOMMITTEEOPINION Number 797 (Replaces Committee Opinion No. 782, June 2019) Committee on Obstetric Practice The American Academy of Pediatrics, the American College of Nurse-Midwives, the Association of Women’s Health, Obstetric and Neonatal Nurses, and the Society for Maternal-Fetal Medicine endorse this document. Although the American Society for Microbiology cannot endorse this document because the content (...) in this Committee Opinion has been updated as highlighted (or removed as necessary) to reflect a limited, focused change in the language regarding penicillin allergy testing, categories for penicillin (ie, low- risk and high-risk of anaphylaxis or severe reaction) (Table 2), and penicillin dose (Figure 3). Prevention of Group B Streptococcal Early-Onset Disease in Newborns ABSTRACT: Group B streptococcus (GBS) is the leading cause of newborn infection. The primary risk factor forneonatalGBSearly-onsetdisease

2020 American College of Obstetricians and Gynecologists

2. Group B streptococcal infection

, but infections are most common in the neonatal period, in older people, and in adults with predisposing factors (i.e., pregnancy, diabetes, immunocompromised). GBS can cause a range of infections including sepsis, cellulitis, pneumonia, and meningitis. This monograph deals with confirmed group B streptococcal infection only. History and exam presence of risk factors fever symptoms of meningitis signs of meningitis symptoms of sepsis signs of sepsis symptoms of pneumonia signs of pneumonia symptoms of UTI (...) Group B streptococcal infection Group B streptococcal infection - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Group B streptococcal infection Last reviewed: February 2019 Last updated: March 2018 Summary Most common cause of early, severe infection in newborns. Also a cause of infection in pregnancy, people with diabetes, immunocompromised people, and older adults. Presentation depends on the age of the patient

2018 BMJ Best Practice

3. Management of Infants at Risk for Group B Streptococcal Disease

of Infants at Risk for Group B Streptococcal Disease Karen M. Puopolo , Ruth Lynfield , James J. Cummings , COMMITTEE ON FETUS AND NEWBORN , COMMITTEE ON INFECTIOUS DISEASES This article has a correction. Please see: Abstract Group B streptococcal (GBS) infection remains the most common cause of neonatal early-onset sepsis and a significant cause of late-onset sepsis among young infants. Administration of intrapartum antibiotic prophylaxis is the only currently available effective strategy (...) and Gynecologists CDC — Centers for Disease Control and Prevention CSF — cerebrospinal fluid EOD — early-onset disease EOS — early-onset sepsis GBS — group B streptococcal IAP — intrapartum antibiotic prophylaxis LOD — late-onset disease MIC — minimum inhibitory concentration NAAT — nucleic acid amplification test PROM — prelabor rupture of membranes ROM — rupture of membranes The Centers for Disease Control and Prevention (CDC) first published consensus guidelines on the prevention of perinatal group B

2019 American Academy of Pediatrics

4. Prevention of Early-Onset Group B Streptococcal Disease in Newborns

Prevention of Early-Onset Group B Streptococcal Disease in Newborns Prevention of Early-Onset Group B Streptococcal Disease in Newborns - ACOG Menu ▼ Prevention of Early-Onset Group B Streptococcal Disease in Newborns Page Navigation ▼ Number 782 (Replaces No. 485, April 2011) Committee on Obstetric Practice The American Academy of Pediatrics, the American College of Nurse-Midwives, the Association of Women’s Health, Obstetric and Neonatal Nurses, and the Society for Maternal-Fetal Medicine (...) organizations are addressed by those organizations. The American College of Obstetricians and Gynecologists has neither solicited nor accepted any commercial involvement in the development of the content of this published product. Prevention of Group B Streptococcal Early-Onset Disease in Newborns ABSTRACT: Group B streptococcus (GBS) is the leading cause of newborn infection (1). The primary risk factor for neonatal GBS early-onset disease (EOD) is maternal colonization of the genitourinary

2019 American College of Obstetricians and Gynecologists

6. Combination therapy with ampicillin and azithromycin improved outcomes in a mouse model of group B streptococcal sepsis. Full Text available with Trip Pro

Combination therapy with ampicillin and azithromycin improved outcomes in a mouse model of group B streptococcal sepsis. Evidence suggests that β-lactam monotherapy of streptococcal infections may incite stronger inflammation and is inferior to combination therapy with macrolides. We hypothesized that use of macrolides alone or in combination with a β-lactam for group B streptococcal (GBS) sepsis would improve outcomes by reducing inflammation.TNF-α was measured from supernatants of RAW 264.7 (...) cells stimulated with GBS isolates, in presence of four treatment regimens: ampicillin alone, azithromycin alone, or combination of azithromycin plus ampicillin. Mouse model of GBS sepsis was developed and treated with same four regimens. Clinical sepsis scores were monitored; serum cytokines (TNF-α, IL-6, IL-10) and chemokines (MIP-1α) were measured at the end.GBS isolates exposed to azithromycin or combination (compared to ampicillin alone) stimulated less TNF production in vitro. In the murine

2017 PLoS ONE

7. Rapid tests for group A streptococcal infections in people with a sore throat

- streptococcal glomerulonephritis (affecting the kidneys), or necrotising fasciitis (a severe infection of soft tissue). Strep A can also cause scarlet fever and invasive group A strep infections. Invasive group A strep infections happen when the bacteria move from the throat into other parts of the body. This can lead to sepsis or streptococcal toxic shock syndrome. The risk of invasive group A strep infections is usually very low, but is higher in older people (aged over 75 years), in whom the risk (...) result? result? Rapid tests for group A streptococcal infections in people with a sore throat (DG38) © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 8 of 47Clearview exact Strep A cassette (Abbott) b Cassette 5×10 4 organisms/ test 5 Qualitative Yes Clearview exact Strep A dipstick (Abbott) c T est strip 5×10 4 organisms/ test 5 Qualitative Yes BD Veritor plus system group A Strep (Becton Dickinson) Cassette 1×10 5

2019 National Institute for Health and Clinical Excellence - Diagnostics Guidance

8. Prevention of early-onset Group B streptococcal sepsis in infants, using universal screening versus risk-based protocols for antibiotic prophylaxis: a systematic review and meta-analysis

Prevention of early-onset Group B streptococcal sepsis in infants, using universal screening versus risk-based protocols for antibiotic prophylaxis: a systematic review and meta-analysis Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears no responsibility (...) (e.g. review, editorial) 2. Not an in vivo animal study 3. No metastases/ only primary tumor 4. No control group 5. Combination therapy or contamination 6. Not about analgesics used in the clinic Full text-screening: As above, with the addition of: 7. No relevant outcome measure reported ">Prioritise the exclusion criteria Example: Two reviewers will independently extract data from each article. We first try to extract numerical data from tables, text or figures. If these are not reported, we

2019 PROSPERO

9. Intrapartum antibiotics for known maternal Group B streptococcal colonization. (Abstract)

Intrapartum antibiotics for known maternal Group B streptococcal colonization. Maternal colonization with group B streptococcus (GBS) during pregnancy increases the risk of neonatal infection by vertical transmission. Administration of intrapartum antibiotic prophylaxis (IAP) during labor has been associated with a reduction in early onset GBS disease (EOGBSD). However, treating all colonized women during labor exposes a large number of women and infants to possible adverse effects without (...) benefit.To assess the effect of intrapartum antibiotics for maternal Group B haemolytic streptococci (GBS) colonization on mortality from any cause, from GBS infection and from organisms other than GBS.We updated the search of the Cochrane Pregnancy and Childbirth Group's Trials Register on 11 March 2014.Randomized trials assessing the impact of maternal IAP on neonatal GBS infections were included.We independently assessed eligibility and quality of the studies.We did not identify any new trials from

2014 Cochrane

10. Vaginal chlorhexidine during labour for preventing maternal and neonatal infections (excluding Group B Streptococcal and HIV). (Abstract)

Vaginal chlorhexidine during labour for preventing maternal and neonatal infections (excluding Group B Streptococcal and HIV). The incidence of chorioamnionitis occurs in between eight and 12 women for every 1000 live births and 96% of cases of chorioamnionitis are due to ascending infection. Following spontaneous vaginal delivery, 1% to 4% of women develop postpartum endometritis. The incidence of neonatal sepsis is 0.5% to 1% of all infants born. Maternal vaginal bacteria are the main agents (...) during labour in reducing maternal and neonatal infections (excluding group B streptococcal and HIV).We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (30 June 2014), reference lists of retrieved reports and journal letters and editorials.Randomized or quasi-randomized trials comparing chlorhexidine vaginal douching during labour with placebo or other vaginal disinfectant to prevent (reduce) maternal and neonatal infections (excluding group B streptococcal and HIV).Two review

2014 Cochrane

11. Clinical Guideline: Early onset Group B streptococcal disease

onset Group B Streptococcal disease 20 Queensland Clinical Guideline: Early onset Group B Streptococcal disease Refer to online version, destroy printed copies after use Page 7 of 26 1 Introduction Streptococcus agalactiae or Group B Streptococcus (GBS) is the most frequent cause of early onset neonatal sepsis. 3,4 Maternal colonisation of the lower genital tract with GBS during pregnancy increases the risk of neonatal infection by vertical transmission. 4 Administration of intrapartum antibiotic (...) • Feed intolerance • Bilious aspirates/vomits • Loose stools Central nervous system • Lethargy • Irritability • Meningeal inflammation • Seizures Queensland Clinical Guideline: Early onset Group B Streptococcal disease Refer to online version, destroy printed copies after use Page 16 of 26 5.2 Investigation of sepsis Any baby with clinical signs of sepsis requires a full diagnostic evaluation and empirical antibiotic therapy started (within 30 minutes 69 ) regardless of adequacy of IAP, other

2016 Queensland Health

12. Guideline Supplement: Early onset Group B Streptococcal Disease

literature o Known resource sites o Internet search engines o Relevant text books 2.5.1 Keywords The following keywords were used in the basic search strategy.[ GBS, EOGBS, early onset Group B Streptococcus, early onset Group B Streptococcal disease, Group B Strep, intrapartum antibiotic prophylaxis, neonatal sepsis, GBS meningitis, Streptococcus agalactiae] Other keywords may have been used for specific aspects of the guideline. Queensland Clinical Guideline Supplement: Early onset Group B Streptococcal (...) of the pregnancy. CIII 8. Offer information about early onset Group B Streptococcal disease to all pregnant women Consensus 9. If GBS testing is indicated, collect a vaginal and rectal or a vaginal and perianal swab Consensus 10. If there are any of the following: ? Signs of neonatal sepsis ? Suspected chorioamnionitis (temperature greater than or equal to 38 o C intrapartum or within 24 hours of birth) ? Previous baby with EOGBSD Collect a full blood count, and blood cultures as a minimum, and treat the baby

2016 Queensland Health

13. Group B Streptococcal Sepsis

Group B Streptococcal Sepsis Group B Streptococcal Sepsis Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Group B Streptococcal Sepsis (...) Group B Streptococcal Sepsis Aka: Group B Streptococcal Sepsis , Group B Streptococcus , GBS Sepsis , Neonatal Sepsis from GBS , Group B Streptococcal Pneumonia II. Epidemiology Most common US cause of and Overall: 2 to 4 per 1000 live births Invasive: 1.8 per 1000 live births Primarily occurs in newborns Very rare after 5 months of age III. Risk Factors <37 weeks Maternal GBS colonization isolated from mother's vagina, or urine Inadequate (if indicated) Prolonged >18 hours Maternal IV

2018 FP Notebook

14. Intrapartum antibiotics for known maternal Group B streptococcal colonization. (Abstract)

Intrapartum antibiotics for known maternal Group B streptococcal colonization. Maternal colonization with group B streptococcus (GBS) during pregnancy increases the risk of neonatal infection by vertical transmission. Administration of intrapartum antibiotic prophylaxis (IAP) during labor has been associated with a reduction in early onset GBS disease (EOGBSD). However, treating all colonized women during labor exposes a large number of women and infants to possible adverse effects without (...) benefit.To assess the effect of IAP for maternal GBS colonization on neonatal: 1) all cause mortality and 2) morbidity from proven and probable EOGBSD, late onset GBS disease (LOD), maternal infectious outcomes and allergic reactions to antibiotics.We updated the search of the Cochrane Pregnancy and Childbirth Group's Trials Register on 10 November 2012.Randomized trials assessing the impact of maternal IAP on neonatal GBS infections were included.We independently assessed eligibility and quality

2013 Cochrane

15. Group B Streptococcal

Group B Streptococcal Group B Streptococcal Disease - Clinical Practice Guideline -- Clinical Recommendation Welcome Search Search Specify your search AAFP.org Patient Care Clinical Practice Guideline Group B Strep Prevention of Perinatal Group B Streptococcal Disease (Endorsed with Qualifications, April 2010) (Affirmation of Value, May 2015) The guideline, Prevention of Perinatal Group B Streptococcal Disease , was developed by the Centers for Disease Control and Prevention and was endorsed (...) no or inadequate prophylaxis without other risk factors, should be observed for ≥ 48 hours. No routine testing is recommended. Well-appearing infants whose mothers received no or inadequate intrapartum antibiotic prophylaxis and are < 37 weeks gestational age or membranes were ruptured ≥ 18 hours before delivery should be observed for ≥ 48 hours and should undergo a limited evaluation. Access article with full recommendations for more information on prevention of perinatal Group B streptococcal disease

2015 American Academy of Family Physicians

16. Prevention of Group B Streptococcal Early-Onset Disease in Newborns: ACOG Committee Opinion Summary, Number 782. (Abstract)

Prevention of Group B Streptococcal Early-Onset Disease in Newborns: ACOG Committee Opinion Summary, Number 782. Group B streptococcus (GBS) is the leading cause of newborn infection. The primary risk factor for neonatal GBS early-onset disease (EOD) is maternal colonization of the genitourinary and gastrointestinal tracts. Approximately 50% of women who are colonized with GBS will transmit the bacteria to their newborns. Vertical transmission usually occurs during labor or after rupture (...) of the CDC 2010 guidelines, "Prevention of Perinatal Group B Streptococcal Disease: Revised Guidelines From CDC, 2010."

2019 Obstetrics and Gynecology

17. Prevention of Group B Streptococcal Early-Onset Disease in Newborns: ACOG Committee Opinion, Number 782. Full Text available with Trip Pro

Prevention of Group B Streptococcal Early-Onset Disease in Newborns: ACOG Committee Opinion, Number 782. Group B streptococcus (GBS) is the leading cause of newborn infection. The primary risk factor for neonatal GBS early-onset disease (EOD) is maternal colonization of the genitourinary and gastrointestinal tracts. Approximately 50% of women who are colonized with GBS will transmit the bacteria to their newborns. Vertical transmission usually occurs during labor or after rupture of membranes (...) of Perinatal Group B Streptococcal Disease: Revised Guidelines From CDC, 2010."

2019 Obstetrics and Gynecology

18. Neonatal Group B Streptococcal Infection in a Tertiary Care Hospital in Saudi Arabia: A 13-year Experience. (Abstract)

Neonatal Group B Streptococcal Infection in a Tertiary Care Hospital in Saudi Arabia: A 13-year Experience. Group B streptococcus (GBS) is a leading cause of neonatal bacterial sepsis and meningitis globally. Studies concerning the incidence and burden of neonatal GBS disease in Saudi Arabia are lacking. This study determined the incidence and burden of GBS infection among neonates in association with maternal GBS screening.A retrospective cohort chart review study included all neonatal GBS (...) < 0.0001), coinciding with the discontinuation of routine universal maternal GBS screening. Median age at presentation was 1 day (range, 0-54 days). We found that 67.3% (n = 37) of mothers were not screened antenatally, 72.9% (n = 27) of whom had neonates present with EOD. Neonates of unscreened mothers were more likely to have GBS disease (P = 0.01) and to present with EOD (P = 0.005). Urinary tract infection was the most common manifestation (47.3%, n = 26), followed by sepsis (43.6%, n = 24

2019 Pediatric Infectious Dsease Journal

19. Isolation and molecular characterization of group B Streptococcus from laboratory Long-Evans rats (Rattus norvegicus) with and without invasive group B streptococcal disease. Full Text available with Trip Pro

Isolation and molecular characterization of group B Streptococcus from laboratory Long-Evans rats (Rattus norvegicus) with and without invasive group B streptococcal disease. Group B Streptococcus (S. agalactiae, GBS) is a Gram-positive opportunistic pathogen that inhabits the respiratory, urogenital and gastrointestinal tracts of humans and animals. Maternal colonization of GBS is a risk factor for a spectrum of clinical diseases in humans and a principle cause of neonatal meningitis (...) and septicaemia.We describe polymicrobial sepsis including GBS in two gravid adult female Long-Evans rats experiencing acute mortality from a colony of long-term breeding pairs. Fluorescent in situ hybridization confirmed GBS association with pathological changes in affected tissues, including the heart and uterus.Characterization of seven GBS strains obtained from clinically affected and non-affected animals indicated similar antibiotic resistance and susceptibility patterns to that of human strains of GBS

2017 Journal of Medical Microbiology

20. Serial Clustering of Late Onset Group B Streptococcal Infections in the Neonatal Unit - a Genomic Re-Evaluation of Causality. Full Text available with Trip Pro

Serial Clustering of Late Onset Group B Streptococcal Infections in the Neonatal Unit - a Genomic Re-Evaluation of Causality. Invasive Group B streptococcus (GBS) is a major cause of serious neonatal infection. Current strategies to reduce early-onset GBS disease have no impact on late-onset disease (LOD). Although GBS LOD is viewed as a sporadic event in the community, LOD arising within the neonatal intensive care unit (ICU) raises questions about mode of acquisition.Following a cluster of 4 (...) be sporadic. Within this neonatal ICU, our data suggest that a single case of LOD GBS sepsis should be considered a potential nosocomial transmission event warranting prompt investigation, heightened infection prevention vigilance and action where required.

2018 Clinical Infectious Diseases

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