Guidelines

We want to see the National guidelines for preventing group B Strep infections in newborn babies updated, to reverse the rising incidence of what is a largely preventable disease. We are constantly campaigning to medical governing bodies for changes to be implemented.

Here you can download and read some of the guidelines from the UK and abroad (this page is updated as guidelines are reviewed).

UK Guidelines

National Institute for Clinical Excellence

Antibiotics for early-onset neonatal infection (2012) – This focuses on the use of antibiotics for the prevention and treatment of early-onset bacterial infection (within 72 hours of birth), including those caused by GBS. Recommends all pregnant women found to carry GBS during their current pregnancy should be routinely offered intravenous antibiotics in labour. Next review 2015.

Antenatal care: routine care for the healthy pregnant woman (issued 2003, reviewed March 2008, March 2011) The 2008 and 2011 reviews did not update the sections relating to GBS in the light of new evidence since 2003, despite requests by a number of stakeholders. Next review 2014.

Induction of labour. Contains no mention of babies born to women carrying GBS. Next review October 2014.

Intrapartum care: management and delivery of care to women in labour guideline. Excludes “additional care for women with known …. group B Streptococcus” Next review currently being scheduled.

Postnatal Care: Routine postnatal care of women and their babies. Contains no mention of babies born to women carrying GBS. Next review July 2015.

Bacterial meningitis and meningococcal septicaemia. The management of bacterial meningitis and meningoococcal septicaemia in children and young peole younger than 16 years in primary and secondary care (ie not in a neonatal unit) Next review June 2013.

Urinary tract infection in children Next review August 2013.

Royal College of Obstetricians & Gynaecologists

Clinical Green Top Guideline No 36 Prevention of early onset neonatal GBS disease (issued 2003, updated 2012). Next review due 2015.

RCOG Information for Patients – Preventing group B Streptococcus (GBS) infection in newborn babies: information for you (issued 2006, updated 2007, 2014. Next update 2016)

2007 RCOG Audit on the prevention of neonatal Group B Streptococcal disease this reports practice in England, Scotland,Wales and Northern Ireland in UK Obstetric Units against the RCOG’s guideline for the Prevention of Early-onset Neonatal Group B Streptococcal Disease. A new audit is underway in 2014. For more information, click here.

2001 Infection & Pregnancy – study group statement

Public Health England

Group B Streptococcal infections

Public Health England’s UK Standards for Microbiology Investigations B 58 Processing Swabs for Group B Streptococcal Carriage (issued 2006, updated 2012) - testing specifically for GBS carriage

Public Health England’s UK Standards for Microbiology Investigations B 28 Investigation of Genital Tract and Associated Specimens (issued 2003, updated 2014) – non-specific testing. Page 14 states, “According to local protocol, patients judged at high risk for the development of group B streptococcal infection may be screened for carriage. Optimum yield will be achieved by selective/enrichment procedures applied to swabs obtained from the vagina and the anorectum”

GBS Epidemiological Data (Next update on England, Wales & Northern Ireland incidence due end November 2014)

NHS National Library for Health’s GBS online learning package

This online learning module was created om 2005 by the NHS National Screening Committee Group B Streptococcus Working Party in collaboration with the National Library for Health, Women’s Health Specialist Library, to promote the Royal College of Obstetricians & Gynaecologists guidelines.

UK National Screening Committee

National Screening Committee Policy Position on antenatal GBS screening was reviewed during 2012. They decided against the introduction of routine antenatal screening of all pregnant women for GBS. Next review due 2015/6.

During the 2013 public consultation, 212 written responses were received (see here) and 207 were published on their website. Of these, 93% were in favour of introducing screening for group B Strep in pregnancy and fewer than 4% were against. You can read the comments submitted to the NSC on their website (click here). This is a hugely disappointing decision which flies in the face of the clear desire of the overwhelming majority of those who cared sufficiently about the issue to comment.

International Guidelines

Australia & New Zealand The Royal Australian and New Zealand College of Obstetricians and Gynaecologists 2003, updated 2012

Belgium - Prevention of perinatal group B Streptococcal infections. Guidelines from the Belgian Health Council, 2003

Canada - The prevention of early-onset neonatal group B Streptococcal disease. Society of Obstetricians and Gynaecologists of Canada, September 2004.

Czech Republic – Měchurová A, Vlk R, Unzeitig V (2007) Doporučené postupy V perinatologii 3. doporučený postup při diagnostice a léčbě streptokoků skupiny B v těhotenství a za porodu. Moderní Gynekologii Porodnictví 16:č 1- s A

France - ANAES. Agence Nationale d`Accreditation et d`Evaluation en Sante (2001) Prévention anténatale du risque infectieux bactérien néonatal précoce.

Germany - Prophylaxis against neonatal sepsis (early onset) by group B Streptococci (2008)

Hong Kong - The Hong Kong Hospital Authority & the Department of Heath 2012

Italy - Societa Italiana di Medicina Perinatale (1996) Proposta: linee-guiada per la prevenzione delle infezioni perinatali da streptococo β-emolitico di gruppo B. Boll Soc Ital Med Perinatale 1:21-24

Netherlands - Nederlandse Vereniging voor Obstetrie en Gynaecologie. NVGO: Preventie van neonatale groep-B-streptokokkenziekte (Gbs-Ziekte). Versie 2.0. (2008)

Poland – Kotarski J, Heczko PB, Lauterbach R, Niemiec T, Leszczyńska-Gorzelak B (2008) Recomendacje polskiego towarzystwa ginekologicznego dotyczące wykrywania nosicielstwa paciorkowców grupy B (GBS) u kobiet w ciąży i zapobiegania zakażeniom u noworodków. Ginekol Pol 79:221-223

United States of America - Centers for Disease Control: Prevention of Perinatal Group B Streptococcal Disease, Revised Guidelines 2010, Standard Operating Procedures for 2010 Guidelines for Laboratorians and more resources on the CDC’s GBS page

Spain - [Prevention of Neonatal Group B Sreptococcal Infection. Spanish Recommendations. Update 2012. SEIMC/SEGO/SEN/SEQ/SEMFYC Consensus Document.] [Article in Spanish] Alós Cortés JI, Andreu Domingo A, Arribas Mir L, Cabero Roura L, de Cueto López M, López Sastre J, Melchor Marcos JC, Puertas Prieto A, de la Rosa Fraile M, Salcedo Abizanda S, Sánchez Luna M, Sanchez Pérez MJ, Torrejon Cardoso R. Enferm Infecc Microbiol Clin. 2012 Jun 1.

Switzerland - Surbek D, Gross A, Seydoux J, Honegger C, Irion O, Drack G (2008) Prévention de l’infection néonatale à Streptocoques du groupe B à début précoce. http://www.sggg.ch/fr/members_news/1004 ( 2008).