Group B Streptococcus (Streptococcus agalactiae) is a leading cause of neonatal septicaemia and meningitis. Intrapartum prophylaxis is indicated in which scenario?

• A Mother is GBS colonised on rectovaginal screen at 35–37 weeks, and current delivery is elective caesarean section with intact membranes
• B Mother with unknown GBS status has preterm labour at 34 weeks ✓
• C Mother's GBS screen was negative 2 weeks ago and she is in term labour
• D Mother is GBS colonised on screen but has elective caesarean before membrane rupture

Explanation

CDC guidelines recommend intrapartum antibiotic prophylaxis (IAP) for GBS when: previous infant with GBS disease, GBS bacteriuria this pregnancy, GBS vaginal/rectal swab positive at 35–37 weeks, unknown GBS status with preterm labour (<37 weeks), membrane rupture ≥18 hours, or intrapartum fever ≥38°C. A mother with unknown GBS status in preterm labour at 34 weeks requires IAP. GBS-positive mothers undergoing elective caesarean section with intact membranes and no labour do NOT require IAP (option A and D). A recent negative screen (option C) rules out prophylaxis.

Reference: Ananthanarayan & Paniker's Textbook of Microbiology, 11th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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