Effects of hospital policies based on 1996 group B streptococcal disease consensus guidelines. The Active Bacterial Core Surveillance Team.

Abstract

To determine whether the 1996 consensus guidelines for prevention of early-onset group B streptococcal disease developed by the Centers for Disease Control and Prevention, ACOG, and the American Academy of Pediatrics are affecting obstetric practice and disease occurrence. Personnel in hospitals with obstetric services in seven surveillance areas completed surveys about their programs, patient populations, and group B streptococcal disease prevention policies. Survey results were linked to group B streptococcal disease cases identified by active surveillance in 1996 and 1997. An early onset case was defined as a case in which group B streptococci were isolated from a sterile site in the 1st 6 days of life. The number of cases in 1996 and 1997 were compared using a paired t test. Linear regression was used to assess hospital characteristics associated with group B streptococcal disease cases. Of 177 hospitals, 165 (93%) responded, and 96 (58%) of those had group B streptococcal disease prevention policies. Hospitals that established or revised their policies in 1996 had a lower mean number of cases in 1997 than in 1996 (0.58 versus 1.29, P = .006). Linear regression analysis, controlling for number of births, indicated that a hospital's having more black mothers and location in particular states were associated with more cases of disease. Citing the 1996 ACOG reference as the source for hospital group B streptococcal disease prevention policy was associated with fewer cases of group B streptococcal disease (P = .038). The publication and adoption of the guidelines were associated with decreasing occurrence of group B streptococcal disease.