Our Chief Executive, Jane Plumb MBE was invited to attend a GBS meeting on Tuesday, 12 April 2016 at ECCMID (European Society of Clinical Microbiology and Infectious Diseases). Jane said: “It was great to be surrounded by people who recognise the importance of testing pregnant women for group B Strep. I outlined the UK’s position and then was asked to explain it – a challenge when the UK’s current strategy is illogical and not protecting as many babies as it could be.”
During the meeting, data were presented from a study by Björklund et al about replacing a risk-based group B Strep prevention strategy with intrapartum testing for group B Strep in Finland. Early data were also presented from studies expected to be published later this year about intrapartum test in France and Italy.
The results Dr Björklund presented looked promising (from 3 to zero cases of early-onset GBS infection between the risk-based and intrapartum testing prevention strategies, plus a small reduction in suspected cases). However, they are relatively small samples, and maternity care in Finland is not set up in the same way as in the UK.
After the meeting, Jane said, “I think intrapartum testing for GBS carriage has real potential, particularly in rapidly establishing group B Strep carriage status for women in preterm labour or with preterm membrane rupture. Preterm babies are at particularly high risk of developing early-onset GBS infection, so knowing whether there is the additional risk of their Mum carrying GBS could target intravenous antibiotics given in labour to minimise that risk.
I don’t think there is yet sufficient evidence that shows whether intrapartum testing would be better at preventing group B Strep infection in newborn babies than either the UK’s current risk-based strategy, or than a strategy based on sensitive testing at 35-37 weeks of pregnancy. Until there is robust evidence, ideally from a UK trial, we just don’t know. Additionally, evidence is needed to show that intrapartum testing would work in the UK maternity care setting, plus detailed cost-benefit analyses would also be needed.”
Group B Strep Support is committed to advocating improvements to GBS prevention strategies based on robust evidence. At this point, there is not enough evidence to suggest we should support universal GBS screening based on intrapartum testing over other methods.
We thank Cepheid for sponsoring Jane’s attendance at the GBS meeting at ECCMID, covering her travel and accommodation costs.
Replacing risk-based early-onset-disease prevention with intrapartum group B streptococcus PCR testing. Björklund V, Nieminen T, Ulander VM, Ahola T, Saxén H. J Matern Fetal Neonatal Med. 2016 Mar 31:1-22.