GBS obstetrics & pediatrics
Marti Perhach
Created on July 12, 2023
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Transcript
based on the US guidelines
obstetric & pediatric knowledge on GBS disease prevention & treatment
Start
QUIZ
Read more
- Prevention of Group B Streptococcal Early-Onset Disease in Newborns
- Management of Infants at Risk for Group B Streptococcal Disease
Sections
Pediatrics
Obstetrics
Question 1/7
What percent of GBS-colonized women will transmit GBS to their newborns?
Section 1: Obstetrics
About 1-2%
About 25%
About 50%
About 79%
A
B
D
C
Question 1/7
Correct!
Section 1: Obstetrics
About half of GBS-colonized women will pass GBS to their newborns. Without intrapartum antibiotic prophylaxis, 1-2% of those newborns will become infected with early-onset GBS disease.
Next
Question 2/7
Section 1: Obstetrics
Which of the following is true when maternal colonization is evident as GBS bacteriuria?
Intrapartum IAP is indicated if detected in current pregnancy
Increased risk for early-onsetBS disease
All of the Above
E
The association with preterm birth was stronger
A
Intrapartum IAP is indicated if detected in current pregnancy
B
Increased risk for early-onset GBS disease
C
At any point during pregnancy and at any colony count, GBS isolated in clean-catch urine specimens is considered a surrogate for heavy vaginal–rectal colonization.
D
Question 2/7
Section 1: Obstetrics
Correct!
Intrapartum IAP is indicated if detected in current pregnancy
Increased risk for early-onsetBS disease
(reword) During any trimester, GBS isolated in clean-catch urine specimens at any colony count is considered a surrogate for heavy vaginal–rectal colonization.
Next
Question 3/7
Section 1: Obstetrics
Among healthcare providers, which of the following is the most commonly identified GBS prenatal screening error?
Screening before 36 weeks
A
Failure to mark the result on the patient’s chart
D
Communicating the result to the patient
C
Incorrectly collecting specimens, usually by culturing the vagina without also culturing the rectum
B
Question 3/7
Section 1: Obstetrics
Correct!
Next
Compared to culturing just the cervix or the vagina without a rectal culture, a culture of the lower vagina AND the rectum substantially increases the culture yield.
FALSE
Question 4/7
True or false: It is reasonable to retest a woman whose original GBS test result is negative when she has not given birth within five weeks of her test.
Section 1: Obstetrics
TRUE
Question 4/7
Section 1: Obstetrics
Correct!
Next
In this clinical scenario, repeat GBS testing may help guide postterm management. Studies suggest that GBS cultures are highly accurate in predicting GBS colonization status at birth if collected within 5 weeks of birth, but, also, that this accuracy decreases significantly if collected more than 5 weeks prior to birth.
Question 5/7
Section 1: Obstetrics
Which of the following is the basis for the IAP strategy to reduce the risk of early-onset GBS disease?
Both A and B
C
None of the Above
D
Reducing the risk of neonatal sepsis
B
Decreasing the incidence of neonatal GBS colonization
A
Question 5/7
Section 1: Obstetrics
Correct!
Adequate maternal drug levels are required to decrease the incidence of GBS colonization in neonates. Adequate antibiotic levels are necessary in the fetus and newborn to reduce the risk of neonatal sepsis.
Next
Question 6/7
Section 1: Obstetrics
Which of the following is NOT true:
Penicillin allergy testing is unsafe during pregnancy
C
When women have a high risk of anaphylaxis, clindamycin is the recommended alternative to penicillin only if the GBS isolate is known to be susceptible to clindamycin.
B
First-generation cephalosporins are recommended for women with reported penicillin allergy indicating they are at a low risk of anaphylaxis or severity of the reaction is unknown.
A
Most women who report being allergic to penicillin are actually penicillin tolerant.
D
Question 6/7
Section 1: Obstetrics
Correct!
Next
Penicillin allergy testing is safe during pregnancy according to the US obstetric guidelines.
FALSE
Question 7/7
True or false: GBS is only a concern at birth
Section 1: Obstetrics
TRUE
Question 7/7
Section 1: Obstetrics
Correct!
Next
GBS can cross intact membranes and infect unborn babies prior to labor starting or membrane rupture. GBS can also infect babies up to several months of age.
Sections
Pediatrics
Obstetrics
FALSE
Question 1/5
True or false: Babies who are born to mothers who tested negative for GBS can become infected with GBS during the first six days of age.
Section 2: Pediatrics
TRUE
Question 1/5
Section 2: Pediatrics
Correct!
Next
Babies can still become infected with group B strep even if the mother tested negative. This can happen if the mother's colonization status has changed between testing and presention for delivery as well as due to incorrect technique in obtaining vaginal and rectal screening cultures or in laboratory processing.
Question 2/5
Section 2: Pediatrics
Which of the following are risk factors associated with late-onset group B strep disease?
Intrapartum maternal fever
B
Preterm birth
A
Duration of membrane rupture
C
Question 2/5
Section 2: Pediatrics
Correct!
Next
Studies have found that the risk for late-onset increased for each week of decreasing gestation and that between 40% to 50% of late-onset cases occur among infants born before 37 weeks. Other clinical intrapartum factors that are predictive of early-onset, such as intrapartum maternal fever and duration of membrane rupture are not predictive of late-onset.
Question 3/5
Section 2: Pediatrics
Which of the following are true regarding late-onset acquisition?
Both of the above
C
There is a significant association between the mother testing positive at the time of birth and at the time of her baby being diagnosed with late-onset.
A
Horizontal acquisition from caregivers other than the mother has been suggested.
B
Question 3/5
Section 2: Pediatrics
Correct!
Next
Question 4/5
Section 2: Pediatrics
Which of the following is true regarding treatment of the birth siblings when a baby who is one of multiple births becomes infected with invasive GBS disease?
The birth siblings should be carefully observed for signs of infection. If signs of illness occur, they should be treated empirically.
A
The recommendation is that all birth siblings receive full antibiotic treatment courses.
B
Question 4/5
Section 2: Pediatrics
Correct!
Next
Currently, there is no evidence supporting full antibiotic treatment courses if GBS disease has not been confirmed.
FALSE
Question 5/5
True or False: GBS disease can reoccur in babies who have completed appropriate treatment for invasive GBS disease.
Section 2: Pediatrics
TRUE
Question 5/5
Section 2: Pediatrics
Correct!
Next
Recurrent neonatal and young infant GBS disease can occur even after treatment of the primary infection has been appropriately completed. A study conducted in Japan during 2011 to 2015 found that recurrence occurred in 2.8% of cases of neonatal GBS infection. Recurrent cases were identified as soon as 3 3 days after completion of the therapy for the first occurrence and up to 54 days after. Takeaway: Parents should be aware that GBS disease can reoccur after treatment of both GBS EOD and LOD.
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Pediatrics
Obstetrics
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