{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T05:45:55Z","timestamp":1789623955730,"version":"build-2803163510"},"reference-count":30,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2018,9,11]],"date-time":"2018-09-11T00:00:00Z","timestamp":1536624000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Queensland Maternity Quality Council"},{"name":"Queensland Maternity"},{"name":"Neonatal Guidelines Project Team"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aust NZ J Obst Gynaeco"],"published-print":{"date-parts":[[2019,6]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Intrapartum chemoprophylaxis reduces early\u2010onset group B streptococcal disease (<jats:styled-content style=\"fixed-case\">EOGBSD<\/jats:styled-content>) in newborns. Some guidelines advise that intrapartum antibiotics should be offered following universal antenatal screening for <jats:styled-content style=\"fixed-case\">GBS<\/jats:styled-content> carriage and others recommend intrapartum antibiotics based on clinical risk factors alone. Since 1999, Queensland guidelines have recommended a risk factor\u2010based approach. We examined trends in <jats:styled-content style=\"fixed-case\">EOGBSD<\/jats:styled-content> rates over time in Queensland in the setting of these guidelines and whether management of cases reflected the recommendations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A state\u2010wide retrospective search of pathology databases, allowing near\u2010complete, population\u2010based case identification, was conducted to detect live\u2010born infants from January 2000 to December 2014 with <jats:styled-content style=\"fixed-case\">GBS<\/jats:styled-content> cultured from blood or cerebrospinal fluid within seven days of age. A nested audit of <jats:styled-content style=\"fixed-case\">EOGBSD<\/jats:styled-content> cases comparing two epochs, 2000\u20132010 and 2011\u20132014, was performed to determine patient characteristics and guideline adherence for each case.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Mean incidence of <jats:styled-content style=\"fixed-case\">EOGBSD<\/jats:styled-content> in Queensland from 2000 to 2014 was 0.33 per 1000 live births (<jats:styled-content style=\"fixed-case\">SD<\/jats:styled-content>\u00b1 0.08) with no changing trend over time. The case\u2010mortality rate in the 2011\u20132014 epoch was 1.2% compared to 11.9% in 2000\u20132004 (odds ratio (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>) 0.09, 95% confidence interval (<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>) 0.002\u20130.67). The proportion of <jats:styled-content style=\"fixed-case\">EOGBSD<\/jats:styled-content> cases who were preterm infants decreased from 29.8% to 13.3% (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 0.36, 95%<jats:styled-content style=\"fixed-case\"> CI<\/jats:styled-content> 0.14\u20130.84). Of cases with risk factors in the 2011\u20132014 epoch, 46% received intrapartum antibiotics compared to 25% in 2000\u20132004 (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 2.49, 95%<jats:styled-content style=\"fixed-case\"> CI<\/jats:styled-content> 0.86\u20137.58, <jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.09).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">EOGBSD<\/jats:styled-content> incidence rate in Queensland remained low during 2000\u20132014. However, both the 2011\u20132014 case\u2010mortality rate and the proportion of preterm cases significantly decreased. Missed opportunities for intrapartum chemoprophylaxis remain.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ajo.12891","type":"journal-article","created":{"date-parts":[[2018,9,11]],"date-time":"2018-09-11T13:28:05Z","timestamp":1536672485000},"page":"422-429","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Early\u2010onset group B streptococcal disease in a risk factor\u2010based prevention setting: A 15\u2010year population\u2010based study"],"prefix":"10.1111","volume":"59","author":[{"given":"Julie C.","family":"Chen","sequence":"first","affiliation":[{"name":"Mater Research Institute The University of Queensland  Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sue","family":"Jenkins\u2010Marsh","sequence":"additional","affiliation":[{"name":"Townsville Hospital and Health Services  Townsville Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vicki","family":"Flenady","sequence":"additional","affiliation":[{"name":"Mater Research Institute The University of Queensland  Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Ireland","sequence":"additional","affiliation":[{"name":"Townsville Hospital and Health Services  Townsville Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meryta","family":"May","sequence":"additional","affiliation":[{"name":"Sullivan Nicolaides Pathology  Brisbane Queensland Australia"},{"name":"Lady Cilento Children's Hospital  Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keith","family":"Grimwood","sequence":"additional","affiliation":[{"name":"Infectious Diseases School of Medicine and Menzies Health Institute Queensland Griffith University  Gold Coast Queensland Australia"},{"name":"Departments of Infectious Diseases and Paediatrics Gold Coast Health  Gold Coast Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helen G.","family":"Liley","sequence":"additional","affiliation":[{"name":"Faculty of Clinical Medicine and Mater Research Institute The University of Queensland  Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,9,11]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(16)30055-X"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.inf.0000128782.20060.79"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.0004-8666.2002.00497.x"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/jpc.12830"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/archdischild-2017-314671"},{"key":"e_1_2_6_7_1","first-page":"1","article-title":"Prevention of perinatal group B streptococcal disease\u2013revised guidelines from CDC, 2010","volume":"59","author":"Verani JR","year":"2010","journal-title":"MMWR Recomm Rep"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(11)61651-6"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajo.12378"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1701-2163(15)30818-5"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.13211"},{"key":"e_1_2_6_12_1","doi-asserted-by":"crossref","first-page":"611","DOI":"10.1542\/peds.2011-1466","article-title":"Policy statement\u2010Recommendations for the prevention of perinatal group B streptococcal (GBS) disease","volume":"128","author":"Baker CJ","year":"2010","journal-title":"Pediatrics"},{"key":"e_1_2_6_13_1","unstructured":"Centers for Disease Control and Prevention.Active Bacterial Core Surveillance Report Emerging Infections Program Network Group B Streptococcus;2016. 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