Abstracts – 2008 - Obstetricia Crítica

cohort study of GBS-positive, penicillin-allergic obstetric patients who delivered atour institution from 2004 through 2005 (N=233). Medical records were analyzedfor type of delivery, gestational age at delivery, antimicrobial sensitivity testing,and antibiotics administered. Antimicrobial sensitivity testing and appropriateprophylactic antibiotic choice were analyzed. "Appropriate antibiotic choice" wasdefined using the 2002 CDC guidelines for GBS prophylaxis. Women with eithera scheduled cesarean delivery or a preterm delivery were excluded fromanalyses. Data were analyzed using Stata 9.0. RESULTS: Overall, 95% (95%confidence interval [CI] 91-97%) of GBS-positive, penicillin-allergic womenreceived antibiotic prophylaxis and only 16% (95% CI 11-21%) of patientsreceived an appropriate antibiotic. The majority of women who were givenantibiotics received clindamycin (83%, 95% CI 77-87%); however, antimicrobialsensitivity testing was performed in only 11% (95% CI 9-17%) of patients. Morewomen received an appropriate antibiotic in 2005 than in 2004 (20% comparedwith 11%, P=0.11). Although the study was underpowered to evaluate themagnitude of increase, the overall prevalence of appropriate antibioticadministration in 2005 was still only 20% (95% CI 13-28%). CONCLUSION:Adherence to the 2002 CDC guidelines for GBS prophylaxis in penicillin-allergicwomen is far from optimal. Improvements are necessary in obtainingantimicrobial sensitivity testing and choosing an appropriate antibiotic for GBSpositivewomen with a reported penicillin allergy. LEVEL OF EVIDENCE: II.Acta Obstet Gynecol Scand. 2008;87(3):260-71.Prevalence of maternal group B streptococcal colonisation in Europeancountries.Barcaite E, Bartusevicius A, Tameliene R, Kliucinskas M, Maleckiene L,Nadisauskiene R.Department of Obstetrics and Gynaecology, Kaunas University of Medicine,Lithuania. eglebarcaite@yahoo.comBACKGROUND: Group B streptococcus (GBS) is a leading cause of neonatalsepsis in many industrialised countries. However, the burden of perinatal GBSdisease varies between these countries. We undertook a systematic review todetermine the prevalence of maternal group B streptococcal colonisation, one ofthe most important risk factor for early onset neonatal infection, and to examinethe serotype distribution of the GBS strains isolated and their susceptibility toantibiotics in European countries. METHODS: We followed the standardmethodology for systematic reviews. We prepared a protocol and a form for dataextraction that identifies key characteristics on study and reporting quality. Thesearch was conducted for the years 1996-2006 including electronic, handsearching and screening of reference lists. RESULTS: Twenty-one studiespresented data on 24,093 women from 13 countries. Among all studies, GBSvaginal colonisation rates ranged from 6.5 to 36%, with one-third of studiesreporting rates of 20% or greater. The regional carriage rates were as follows:Eastern Europe 19.7-29.3%, Western Europe 11-21%, Scandinavia 24.3-36%,and Southern Europe 6.5-32%. GBS serotypes III, II and Ia were the mostfrequently identified serotypes. None of the GBS isolates were resistant to