To the Editor.
The new 1997 guidelines for the management of group B streptococcal (GBS) infections in newborns have been recently published.1 2 The major change we wish to address is the use of intrapartum chemoprophylaxis in GBS carriers identified by anogenital cultures.
The 1992 guidelines recommended intrapartum chemoprophylaxis only if risk factors were present (preterm rupture, preterm labor, fever during labor, multiple births, and rupture of membranes >18 hours).3 The current recommendation is to offer intrapartum chemoprophylaxis to all GBS carriers regardless of risk factors. We agree and offer our ongoing experience with this new strategy.
Our institution experienced an outbreak of invasive neonatal GBS over a 2-month period in early 1993 that saw our attack rate climb to 25 per 1000 versus the typical 0.5 to 1.5 per 1000. During this period 10 patients had positive laboratory evidence for GBS and objective clinical findings (ie, sepsis...