{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T04:17:30Z","timestamp":1777609050977,"version":"3.51.4"},"reference-count":16,"publisher":"BMJ","issue":"11","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2017,10,2]]},"published-print":{"date-parts":[[2017,11]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>\n                      To describe the impact on early-onset group B\n                      <jats:italic>Streptococcus<\/jats:italic>\n                      (EOGBS) infection rates following reversion from screening-based to risk-based intrapartum antimicrobial prophylaxis (IAP) for prevention.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Maternity services provided by secondary healthcare organisation in North West London.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>All women who gave birth in the healthcare organisation between April 2016 and March 2017. There were no exclusions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Observational study comparing EOGBS rates in the postscreening period (2016\u20132017) with prescreening (2009\u20132013) and screening periods (2014\u20132015).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Local guidelines for risk-based IAP were reintroduced in April 2016. Compliance with guidelines was audited. Gestational age, mode of delivery, maternal demographics and EOGBS rates in three time periods were compared using Poisson regression analysis. EOGBS was defined through GBS being cultured from blood, cerebrospinal fluid or other sterile fluids within 6 days of birth.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary outcome<\/jats:title>\n                    <jats:p>EOGBS rates\/1000 live births in prescreening, screening and postscreening periods<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Incremental changes in maternity population were observed throughout the study period (2009 onwards), in particular the ethnic profile of mothers. Of the 5033 live births in postscreening period, 9 babies developed EOGBS infection. Only one of the mothers of affected babies had a risk factor indicating use of IAP. Comparison of postscreening period with screening period showed a fivefold increase in EOGBS rates after adjustment for ethnicity (1.79 vs 0.33\/1000 live births; risk ratio =5.67, p=0.009). There was no significant difference between prescreening and postscreening periods with rates of infection reverting to their prescreening level.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study provides further evidence of efficacy of screening-based IAP compared with risk-based IAP in prevention of EOGBS in newborns in an area of high incidence.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2017-018795","type":"journal-article","created":{"date-parts":[[2017,11,19]],"date-time":"2017-11-19T23:40:11Z","timestamp":1511134811000},"page":"e018795","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":13,"title":["Early-onset group B\n                    <i>Streptococcus<\/i>\n                    (EOGBS) infection subsequent to cessation of screening-based intrapartum prophylaxis: findings of an observational study in West London, UK"],"prefix":"10.1136","volume":"7","author":[{"given":"Guduru","family":"Gopal Rao","sequence":"first","affiliation":[{"name":"Department of Microbiology, Northwick Park Hospital, Harrow, UK"},{"name":"Faculty of Medicine, Imperial College London, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jane","family":"Townsend","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Northwick Park Hospital, Harrow, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Stevenson","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Northwick Park Hospital, Harrow, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Grace","family":"Nartey","sequence":"additional","affiliation":[{"name":"Department of Maternity Services, Northwick Park Hospital, Harrow, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen","family":"Hiles","sequence":"additional","affiliation":[{"name":"Department of Research and Development, Northwick Park Hospital, Harrow, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul","family":"Bassett","sequence":"additional","affiliation":[{"name":"Statsconsultancy, Amersham, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Theresa","family":"Lamagni","sequence":"additional","affiliation":[{"name":"National Infection Service, Public Health England Colindale, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard","family":"Nicholl","sequence":"additional","affiliation":[{"name":"Neonatology Unit, Northwick Park Hospital, Harrow, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2017,11,19]]},"reference":[{"key":"2025121515294545000_7.11.e018795.1","doi-asserted-by":"publisher","DOI":"10.1136\/adc.2009.178798"},{"key":"2025121515294545000_7.11.e018795.2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cit337"},{"key":"2025121515294545000_7.11.e018795.3","doi-asserted-by":"publisher","DOI":"10.1136\/archdischild-2016-310863.3"},{"key":"2025121515294545000_7.11.e018795.4","unstructured":"RCOG. 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Neonatal infection (early onset): antibiotics for prevention and treatment. https:\/\/www.nice.org.uk\/guidance\/cg149 (accessed 9 Jul 2017)."},{"key":"2025121515294545000_7.11.e018795.7","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1046\/j.1469-0691.2001.00196.x","article-title":"Prevention of group B streptococcal neonatal disease: a plea for a European consensus","volume":"7","author":"de la Rosa Fraile","year":"2001","journal-title":"Clin Microbiol Infect"},{"key":"2025121515294545000_7.11.e018795.8","doi-asserted-by":"publisher","DOI":"10.1016\/S1701-2163(15)30818-5"},{"key":"2025121515294545000_7.11.e018795.9","first-page":"1","article-title":"Prevention of perinatal group B streptococcal disease-revised guidelines from CDC, 2010","volume":"59","author":"Verani","year":"2010","journal-title":"MMWR Recomm Rep"},{"key":"2025121515294545000_7.11.e018795.10","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2016-014634","article-title":"Outcome of a screening programme for the prevention of neonatal invasive early-onset group B Streptococcus infection in a UK maternity unit: an observational study","volume":"7","author":"Gopal Rao","year":"2017","journal-title":"BMJ Open"},{"key":"2025121515294545000_7.11.e018795.11","unstructured":"Lamagni TL , Henderson K , Efstratiou A , et al . Invasive GBS infection in England, 2009: associated risk factors. XVIII lancefield international symposium on streptococci and streptococcal diseases, 2011."},{"key":"2025121515294545000_7.11.e018795.12","unstructured":"Royal college of Obstetricians and Gynaecologists. Audit of current practice inpreventing early-onset neonatalgroup B streptococcal diseasein the UK. 2015 https:\/\/www.rcog.org.uk\/globalassets\/documents\/guidelines\/research-audit\/gbs-audit-first-report.pdf (accessed 21 Jul 2017)."},{"key":"2025121515294545000_7.11.e018795.13","unstructured":"Royal college of Obstetricians and Gynaecologists. Audit of current practice in preventing early-onset neonatal group B streptococcal disease in the UK. 2016 https:\/\/www.rcog.org.uk\/globalassets\/documents\/guidelines\/research-audit\/gbs-audit-second-report-january-2016.pdf (accessed 21 Jul 2017)."},{"key":"2025121515294545000_7.11.e018795.14","unstructured":"Eastwood KA , Craig S , Sidhu H , et al . Prevention of early-onset Group B Streptococcal disease - The Northern Ireland experience. 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