GBS

Question 1

Indications for intrapartum treatment of GBS

Answer 1

Positive GBS swab, unknown status and ruptured >18 hrs, positive NAAT, negative NAAT with risk factors, GBS bacteriuria, GBS sepsis in prior pregnancy

Question 2

Risk factors for GBS EOB that necessitate treatment in GBS unknown patient (or negative NAAT)

Answer 2

Rupture >18 hours, birth <37 weeks, intrapartum fever >100.4, positive NAAT, GBS + culture in prior pregnancy

Question 3

Who does not need GBS prophylaxis?

Answer 3

Those with a negative GBS culture that is still valid and women undergoing pre-labor c-section with intact membranes, term unknown GBS status and rupture <18 hours, negative NAAT without risk factors

Question 4

GBS unknown during current pregnancy, hx of GBS + culture in prior pregnancy

Answer 4

consider intrapartum antibiotics as they have a 50% chance of colonization

Question 5

Incidence of GBS

Answer 5

10-30% of women are currently colonized

Question 6

How long is a GBS swab good for

Answer 6

5 weeks

Question 7

GBS bacteriuria <10,000 cfu

Answer 7

considered heavy maternal vaginal-rectal colonization and should be treated empirically during labor without need for GBS swab at 36-37.6 weeks

Question 8

When should you acutely treat GBS bacteriuria?

Answer 8

at 105 cfu or higher regardless of whether patient is symptomatic or not

Question 9

GBS bacteriuria <105 cfu

Answer 9

no acute treatment needed, but prophylaxis at delivery is still indicated

Question 10

GBS screening in patient’s with a PCN allergy

Answer 10

indicate allergy on sample so lab can test for susceptibility to clindamycin (this cannot be done on NAAT samples)

Question 11

treatment of choice for acute GBS bacteriuria

Answer 11

Keflex (do not treat with clinda as this is poorly concentrated in the urine)

Question 12

rLTCS with ruptured of membranes and GBS positive

Answer 12

Ancef can be used for GBS prophylaxis and presurgical prophylaxis