While waiting for a vaccine: opportunities for optimization of neonatal group B streptococcal (GBS) disease prevention in Israel

Objective:to quantify effects of different strategies for decreasing neonatal early onset gbs sepsis (eogbs) in israel.study design:a risk allocation model for eogbs among infants ≥ 35w was adapted to israeli data. effects of strategies for antepartum (aps) and intrapartum (ips) screening, and intrapartum (iap) and/or postpartum antibiotic prophylaxis (pap) were calculated.results:estimated eogbs attack rates (ar) with aps in 90%, iap in 90%, may reduce ar to 0.18/1000. a rapid intrapartum test would further decrease ar to 0.16/1000, while reducing iap from 21.3 to 12.5% of women. for babies with risk factors and gbs+ who do not receive iap, further risk reduction could be achieved by pap.conclusion:iap remains the main intervention to decrease eogbs. iap and pap together may reduce eogbs present incidence by 40%. combining rapid intrapartum screening with selective iap and selective pap for remaining gaps, would be the most efficient strategy.