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Group B Streptococcus Screening and Treatment Adherence in Pregnancy: A Retrospective Cohort Study and Opportunities for Improvement
Journal article   Open access   Peer reviewed

Group B Streptococcus Screening and Treatment Adherence in Pregnancy: A Retrospective Cohort Study and Opportunities for Improvement

Donna A. Santillan, Alexander J. Hubb, Taryn E. Nishimura, Sandra Rosenfeld-O'Tool, Kathleen J. Schroeder, Jona M. Conklin, Alexandra E. Karras, Serena B. Gumusoglu, Debra S. Brandt, Emily Miller, …
AJPM Focus, Vol.1(2), 100028
12/01/2022
DOI: 10.1016/j.focus.2022.100028
PMCID: PMC10546507
PMID: 37791233
url
https://doi.org/10.1016/j.focus.2022.100028View
Published (Version of record) Open Access

Abstract

•Screening for Group B streptococcus (GBS) impacts many maternal–fetal outcomes.•GBS screening guidelines are continually evolving and compliance varies.•Via a retrospective cohort study, we found high (89%) adherence across providers.•Significant differences in compliance were found between clinic subsets.•High compliance may attenuate antibiotic resistance. Pregnancy is a time of increased healthcare screening, and past adherence to evolving guidelines inform best practices. While studies of Group B streptococcus (GBS) guideline adherence have focused primarily on treatment of GBS carriers, this study broadly evaluated long-term adherence to both GBS screening and treatment guidelines. Adherence was evaluated across provider types (Obstetrics and Gynecology, Certified Nurse Midwives, and Family Medicine). We conducted a retrospective cohort study. Demographic and clinical information were extracted from all prenatal care and delivery patients at a single institution in a single year (Institutional Review Board Approval# 201207778). Vancomycin prescriptions in pregnancy were tracked for 10 years to determine long-term adherence. Adherence was defined as no deviation from 2010 GBS screening and treatment guidelines. Adherence occurred in 89% (1610/1810) of patients. Reasons for deviations from guidelines could not always be determined. There was no significant difference in maternal age, race, prenatal provider type, provider type at delivery, gestational age at delivery, delivery mode, or whether antibiotic sensitivities were performed between complaint and non-compliant groups. Significant differences in adherence were found between Obstetric clinics (High Risk Obstetrics Clinic, Maternal Fetal Medicine Fellows Clinic, Continuity of Care Clinic, and Faculty Private Clinic) (P<0.0001) and between the Faculty Family Medicine Clinic and Resident Family Medicine Clinic (P=0.001). Vancomycin prescription practice did not change significantly over a 10-year period. High rates of adherence with GBS screening and treatment guidelines in pregnancy have positive implications for reducing antibiotic resistance. Given evolving guidelines, there is a need to periodically evaluate adherence and to re-educate providers about standard practices and best documentation practices.
 Pregnancy Group B Streptococcus Guideline adherence Infection Screening Treatment

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