In these initial trials, relapse occurred commonly and was thought to be a consequence of colonization of sexual contacts. Cochrane database of systematic reviews (Online) 2005(1):CD000451. Baker CJ, Barrett FF, Gordon RC, Yow MD. Christensen KK, Dahlander K, Linden V, Svenningsen N, Christensen P. Obstetrical care in future pregnancies after fetal loss in group B streptococcal septicemia. Prevention of early-onset group B streptococcal disease: another look at single-dose penicillin at birth. Other strategies to reduce maternal colonization and vertical transmission have been studied, including intramuscular intrapartum antibiotic prophylaxis (67), antenatal (oral or intramuscular) antibiotics (69--71), and chlorhexidine vaginal wipes or douches (72--76); however, none has proven to be effective at preventing early-onset disease. Muñoz P, Coque T, Rodriguez Creixems M, Bernaldo de Quirós JCL, Moreno S, Bonza E. Group B streptococcus: A cause of urinary tract infection in nonpregnant adults. Most data on the risk for early-onset GBS disease among infants born to women with GBS bacteriuria are derived from studies of significant GBS bacteriuria (generally >105 colony-forming units per millimeter of urine) (47--49). Ernest JM, Givner LB. Cellulitis, foot ulcers, abscess and infections of decubitis ulcers are the most common. provided as a service to MMWR readers and do not constitute or imply Institution of universal screening for group B. Puopolo K, Eichenwald E. No change in the incidence of ampicillin-resistant, neonatal, early-onset sepsis over 18 years. Sufficient amounts of GBS capsular polysaccharide type-specific serum IgG in mothers have been shown to protect against invasive disease in their infants (51,115--118). Although GBS vaccines might be expected to aid in reduction of racial disparities and prevention of invasive GBS disease among adults and infants (both early- and late-onset), continued exploration of other means to improve and strengthen GBS prevention efforts is warranted. Baltimore, MD: Williams & Wilkins; 1985. de la Rosa M, Perez M, Carazo C, Pareja L, Peis JI, Hernandez F. New Granada medium for detection and identification of group B streptococci. Impact of intrapartum antibiotics on the care and evaluation of the neonate. Although maternal GBS colonization might increase clinical suspicion for early-onset GBS disease in an infant, in the era of universal screening, >60% of early-onset GBS cases have occurred among infants born to women who had a negative prenatal GBS culture screen (102,203,204). Christensen RD, Rothstein G, Anstall HB, Bybee B. Granulocyte transfusions in neonates with bacterial infection, neutropenia and depletion of mature marrow neutrophils. Discharge from the hospital to home parenteral antibiotic therapy can be planned when the patient is afebrile, the white blood cell count is returning to baseline, and procalcitonin or C-reactive protein are in the normal range. Most studies, including population-based multicenter studies, have found stable (231--239) or decreasing (240,241) rates of non-GBS early-onset sepsis during a period of increasing use of intrapartum antibiotic prophylaxis for GBS. Optional direct broth testing:** Detection of GBS can be determined directly from broth media using latex agglutination, probes or nucleic acid amplification tests (NAAT) such as PCR. Intrapartum antibiotic prophylaxis to prevent early-onset GBS disease is not recommended as a routine practice for cesarean deliveries performed before labor onset on women with intact amniotic membranes, regardless of the GBS colonization status of the woman or the gestational age of the pregnancy (CIII). * Patients with a history of any of the following after receiving penicillin or a cephalosporin are considered to be at high risk for anaphylaxis: anaphylaxis, angioedema, respiratory distress, or urticaria. Balter S, Zell ER, O'Brien KL, et al. Maternal anaphylaxis associated with GBS prophylaxis was reported in the early 1990s (97); since the release of the 1996 guidelines, four reports of nonfatal cases of anaphylaxis associated with GBS chemoprophylaxis in the United States have been published (98--101). Recommended regimens for intrapartum antibiotic prophylaxis for prevention of early-onset group B streptococcal (GBS) disease*. Data are not sufficient to make recommendations regarding the timing of procedures intended to facilitate progression of labor, such as amniotomy, in GBS-colonized women. FIGURE 4. Barber EL, Zhao G, Buhimschi IA, Illuzzi JL. 2001 Jun;80(6):511--8. Christensen RD, Rothstein G, Hill HR, Hall RT. Tricuspid valve involvement is frequently seen in intravenous drug abusers. J Microbiol Methods 2008;73:263--5). Whether any observed increase in ampicillin-resistant E. coli is attributable to the use of intrapartum antibiotics for GBS prophylaxis is unclear because ampicillin resistance among E. coli isolates has increased communitywide (249).