An obstetric approach to the prevention of early-onset group B beta-hemolytic streptococcal sepsis.

Group B beta-hemolytic streptococcus is one of the most common causes of neonatal sepsis. Despite its relationship to neonatal morbidity and mortality, no consensus exists for an approach to its prevention. Several characteristics of the organism such as high maternal carriage rates, the intermittent nature of this carriage, and the failure of antibiotics to permanently eliminate carriage have limited the success of proposed intervention protocols. In this clinical opinion we review characteristics of the organism and previously suggested intervention protocols. Then, based on this review and an analysis of recently published data, a protocol focusing on preterm births is presented. This proposal favors intrapartum treatment of all mothers who are delivered of preterm infants and who are either carriers of group B beta-hemolytic streptococci or whose carriage status is unknown. A comparison of the costs and benefits of this and other approaches is made.