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Am J Obstet Gynecol. 1998 Jul;179(1):77-9.

Compliance with the Centers for Disease Control and Prevention antenatal culture protocol for preventing group B streptococcal neonatal sepsis.

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  • 1Department of Obstetrics and Gynecology, Genesee Hospital and University of Rochester School of Medicine and Dentistry, New York, USA.

Abstract

OBJECTIVE:

Our purpose was to measure the compliance with the Centers for Disease Control and Prevention antenatal culture protocol for preventing group B streptococcal sepsis after extensive education of physicians and staff.

STUDY DESIGN:

After 2 months of educational activities to familiarize attending physicians, nurses, and laboratory staff with the guidelines, a retrospective chart review of all vaginal deliveries over a 6-month period were analyzed for protocol compliance and failures either of culturing or antibiotic use.

RESULTS:

Overall, there was a 20% prevalence rate of group B streptococci found at > or = 35 weeks' gestation. The enhanced broth preincubation did not significantly increase this rate. Compliance with the protocol was 80% for appropriately timed cultures and 84% for use of antibiotics; 0.7% received unindicated antibiotics.

CONCLUSION:

The area of greatest compliance failure was neglecting to treat women with antepartum risk factors that did not require antepartum cultures: previously affected neonates with group B streptococcal sepsis, antepartum group B streptococcal bacteriuria, and preterm labor and delivery. Twenty-one percent (14/66) of women having these antepartum risk factors were not treated. Protocol failure resulting in no cultures being done occurred in 9% of the women studied (87/956). Further education and quality assurance activities can lower these numbers. There were no cases of group B streptococcal sepsis during the 6 months of this study.

Comment in

PMID:
9704768
[PubMed - indexed for MEDLINE]
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