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CDC Algorithm for Secondary Prevention of Early-Onset Neonatal Sepsis Due to Group B Streptococcus

Purpose: To manage a newborn who may have been exposed to Group B Streptococcus (GBS) using the 2010 CDC guidelines.

Description

The Centers for Disease Control and Prevention (CDC) developed a number of algorithms for the management of a neonate depending on the risk for Group B Streptococcal infection (GBS).


Parameters:

(1) signs of neonatal sepsis

(2) maternal chorioamnionitis

(3) indications for GBS prophylaxis

(4) adequacy of prophylaxis

(5) features of pregnancy

 

Neonatal Sepsis

Chorio-amnionitis

GBS Prophylax

Adequate Prophylax

Pregnancy Features

Step

Y

NA

NA

NA

NA

1

N

Y

NA

NA

NA

2

N

N

N

NA

NA

3

N

N

Y

Y

NA

4

N

N

Y

N

see below

5

N

N

Y

N

see below

6

 

Step 5: >= 37 weeks gestation AND membrane rupture < 18 hours

Step 6: < 37 weeks gestation OR membrane rupture >= 18 hours

 

Step

Management

1

Full sepsis workup and start antibiotic therapy.

2

Limited workup and start antibiotic therapy.

3

Routine clinical care.

4

Observe for >= 48 hours. Workup and treat if septic.

5

Observe for >= 48 hours. Workup and treat if septic

6

Limited workup. Observe for >= 48 hours. Treat if septic.

 


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Specialty

Objective

ICD-10