PC.92 Invasive Group B Streptococcus in the neonate: To screen or not to screen? Experience from a level 2 NICU

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Many developed countries screen for Group B Strep (GBS); however, the UK employs a Risk Based approach for selecting mothers to receive intrapartum antibiotic prophylaxis (IAP). There is pressure for screening from one-sided arguments in the UK press, despite the Risk Based approach continuing to be justifiable at the national level. However, a detailed consideration of GBS epidemiology by Public Health England in 2013 describes wide variation in the rate of GBS infection within English regions. If local incidence was to exceed a threshold for the viability of a screening programme, or the risk factors used to select mothers are no longer appropriate, then a change in policy at the local level may be indicated. The primary aim of this project was to establish the incidence of early onset (EOGBS) at our level 2 NICU (Royal United Hospitals Bath). Our secondary aim was to look in detail at the risk factors present in each of the EOGBS cases. Data was pulled from all recorded invasive GBS cases over a seven year period (2006 to 2012). The incidence of EOGBS was 0.62/1000 births. Only 30% of recorded cases met the Risk Based criteria to receive IAP, and less than half of these cases were recorded as actually receiving the IAP. A considerable 38% of GBS cases presented with no risk factors at all. More research into the appropriateness of some of the ‘risks’ used in this approach and more guidance as to the threshold for screening initiation is needed.

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