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Group B Strep Prevention (GBS, baby strep, Group B streptococcal bacteria)

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State and Local Health Departments

What you Can Do

What your state can do to help prevent neonatal group B strep disease:

I. Educational & promotional campaigns
II. Assessment & surveillance activities

Learn more about CDC's group B strep mission and program

I. Educational & promotional campaigns


Establish a local coalition of key partners to support implementation of the CDC and the American College of Obstetricians and Gynecologists (ACOG) guidelines for group B strep disease prevention issued in 2002.

Partners within the health department may include: health communications specialists, epidemiologists, and behavioral scientists. They may come from a variety of departments: communicable diseases, maternal and child health, and groups working on perinatal Hepatitis B and HIV prevention.

Partners outside the health department may include: local hospitals with obstetric services, HMOs, local chapters of ACOG or the American Academy of Pediatrics (AAP), or American Academy of Family Physicians (AAFP), local clinical microbiologists, local nurse midwife organizations

Activities the coalition can undertake include:
    a. Presentation of Grand Rounds, educational workshops and conferences about the new group B strep prevention guidelines.
    b. Assistance to local HMOs or hospitals attempting to develop group B strep prevention protocols consistent with the new guidelines
    c. Promotion of existing health communication tools for providers and the general public (for examples click here (link to order form))
    d. Development of new communication tools appropriate to your state; in particular materials addressing barriers to implementation of universal screening may be useful.

Develop and pilot test new health communications materials targeted at the following populations:

  1. Hispanics
  2. Teenagers
  3. Women of Low Literacy
  4. African Americans



Conduct surveys of clinical laboratories to assess compliance with CDC recommendations for prenatal screening specimen collection and processing, providing feedback and follow-up with laboratories that are not complying.

MMWR article summarizing results of a group B strep laboratory methods survey that was conducted in GA, CT and MN (MMWR 1999;48:426-428):

Sample copy of the laboratory survey used in this study (Adobe Acrobat 4 pages)


Survey hospitals with obstetric services, or health care providers to collect data on group B strep prevention strategies and how they are implemented. In addition, provide feedback and follow-up with hospitals that are not complying with the recommendations in the 2002 guidelines.

MMWR article summarizing results of a hospital survey (MMWR 2000:49:936-940)

View a copy of the hospital survey that was used in this study (Adobe Acrobat 7 pages)

MMWR article summarizing results of a prenatal care provider survey in CT and MN (MMWR 2000; 49:228-232)

View a copy of a recent prenatal care provider survey used in Minnesota (Adobe Acrobat 2 pages)


Review a random sample of labor and delivery records to assess the prevalence of prenatal GBS screening and the proportion of GBS positive women who receive intrapartum antibiotics in your state.
** See about collaborating with your state STD, HIV, Perinatal Hepatitis B Prevention campaign, or state immunization programs**

To read an article about such a survey, consult the following reference:
Schuchat A. et al. Integrated monitoring of a new group B streptococcal disease prevention program and other perinatal infections. Maternal Child Health Journal 2002;6:107-114

MMWR article summarizing prenatal HIV testing results from 8 states that used this kind of survey (MMWR 2002; 51:1013-16)

Sample data collection form (Adobe Acrobat 2 pages)

Sample instructions for chart abstraction (Adobe Acrobat 10 pages)

Sample instructions on how to select a random sample of births in your survey (Adobe Acrobat 2 pages)

  D. Convince your state to implement two group B strep-related questions that are available to all states on the optional component of the Pregnancy Risk Assessment Monitoring Survey (PRAMS) (exit site). Provide feedback to prenatal care providers based on survey results for your state.

View the PRAMS questions available to states on the optional component ( 2 pages)
  E. Require that invasive neonatal GBS Disease be reportable to State Health Departments.
  F. Solicit support for the addition of GBS prenatal testing or maternal GBS colonization to your state’s birth certificates for tracking purposes.

Develop and pilot test new health communications materials addressing the following groups that are transitioning to the screening based approach:

  1. Clinical microbiology laboratories
  2. Clinicians and Hospitals
  3. Health Care Providers

Conduct Laboratory-based surveillance for invasive neonatal Group B Strep Disease. (Nationally, incidence of neonatal disease in the 1st week of life ranges from 0.2 to 1 case per 1,000 live births; late-onset disease typically has an incidence of 0.3-0.4 cases per 1,000 live births.)

Sample data collection forms (Adobe Acrobat 3 pages)

Learn more about the CDC’s laboratory based surveillance for group B strep


If your state has a prenatal testing law, incorporate prenatal testing for group B strep into the law


If you choose to conduct any of the above surveillance activities, you may want to track how your state is doing relative to two federal targets for early-onset group B strep disease prevention:

Healthy People 2010 Objectives

Objective 14-16 : Reduce invasive early onset group B streptococcal disease.
The target set in this objective is 0.5 new cases per 1,000 live births for all racial and ethnic groups.

Government Performance and Results Act Target

II-J. Infectious Diseases Control
Group B Streptococcal Disease

Performance Measure set in FY01: Reduce the incidence of perinatal group B streptococcal infections to 0.3 per 1,000 live births.

Page Last Modified: April 20, 2008
Content Last Reviewed: April 20, 2008
Content Source: National Center for Immunization and Respiratory Diseases
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