Table 5.

Integrated Strategies for Prevention of Early-Onset Neonatal Group B Streptococcal Infections

Screening for GBS ColonizationNoneRectovaginal
Culture at 35–37
Weeks
Strep B OIA at
Delivery
Ideal Intrapartum
Screening Test
Criteria for intrapartum prophylaxisEGA <34 weeksor Risk factor* +EGA <34 weeks or GBS culture + or EGA <37 weeks and risk factor* +EGA <31 weeks or Strep B OIA + or Risk factor* +GBS screen + or EGA <31 weeks and risk factor* +
Criteria for neonatal prophylaxisEGA <28 weeks or EGA <37 weeks and risk factor* +EGA <28 weeks or Two of: EGA <37 weeks Risk factor* + GBS culture +Two of: EGA <34 weeks Strep B OIA + Risk factor* +GBS screen + and risk factor* + or GBS screen + and <37 weeks or Risk factor* + and <28 weeks
Women treated per 1000 births111  247  242  148  
Neonates treated per 1000 births 15   31   21   26  
Women treated per case prevented 70  105  101   55  
Neonates treated per case prevented 10   13    9   10  
GBS cases prevented (%)53.078.480.189.6
Cost per case prevented$2142$10 843$8443$9168
  • Abbreviation: GBS, group B streptococcus.

  • * Prolonged rupture of membranes >18 hours or intrapartum fever >38.0°C.