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Infectious Diseases in Obstetrics and Gynecology
Volume 2010 (2010), Article ID 369654, 3 pages
http://dx.doi.org/10.1155/2010/369654
Research Article

Unnecessary Workup of Asymptomatic Neonates in the Era of Group B Streptococcus Prophylaxis

1Department of Pediatrics, Medical College of Georgia, Augusta, GA 30912, USA
2Department of Obstetrics and Gynecology, Medical College of Georgia, Augusta, GA 30912, USA
3Department of Sugery, Mercer University School of Medicine, Macon, GA 31207, USA
4Georgia Prevention Instuite, Medical College of Georgia, Augusta, GA 30912, USA

Received 10 November 2009; Revised 14 May 2010; Accepted 19 May 2010

Academic Editor: Bryan Larsen

Copyright © 2010 Brad Buckler et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Asymptomatic term neonates born to mothers who are Group B Streptococcus (GBS) unknown or GBS positive but “inadequately” treated prior to delivery do not require invasive laboratory evaluation. We conducted a retrospective cohort study of mother/baby dyads born from January 1, 2005 until September 30, 2007 at the Medical College of Georgia. Their current protocol is to obtain a Complete Blood Count with Differential (CBC with D), Blood Culture (BC), and C-reactive protein (CRP) after birth. Mother/baby dyads ( 𝑛 = 2 4 2 ) that met inclusion criteria were reviewed. Of these 242 babies 25 (10%) were started on antibiotics after the initial lab values were known. None of the blood cultures were positive and the CRP's were normal. The 2002 GBS guidelines call for laboratory evaluation of “at-risk” neonates, but the workup of these babies is not only costly, it does not provide any advantage over old fashioned clinical observation for the evaluation and treatment of early onset GBS sepsis.