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Revised GBS Prevention Guidelines

7/22/2019

 

Karen M. Puopolo, MD, PhD

Karen M. Puopolo, MD, PhD
Karen M. Puopolo, M.D., Ph.D. is a neonatologist who specializes in neonatal infectious diseases.    Dr. Puopolo is an Associate Professor of Pediatrics on the faculty of the University of Pennsylvania Perelman School of Medicine.  She is a member of the Division of Neonatology at The Children’s Hospital of Philadelphia, and Section Chief for Newborn Medicine at Pennsylvania Hospital.  Dr. Puopolo received her undergraduate degree in physics from Yale University, and went on to obtain her M.D. as well as a Ph.D. in molecular physiology from the Tufts University School of Medicine in Boston.  She completed Pediatric residency and Neonatal-Perinatal fellowship training at Boston Children’s Hospital.  Dr. Puopolo was appointed to the faculty of Harvard Medical School from 2000-2014 where she was a physician and researcher at the Brigham and Women’s Hospital and the Channing Laboratory.  She began her neonatal research career as a laboratory-based scientist investigating mechanisms of virulence in Group B Streptococcus.  Her research now focuses on neonatal sepsis epidemiology and risk assessment.  In collaboration with Dr. Gabriel Escobar, she developed and validated models to quantify the risk of neonatal early-onset sepsis among term and late preterm infants.  These models form the basis of the “sepsis risk calculator” that is transforming the U.S. national approach to neonatal early-onset sepsis.  She is currently funded by the National Institutes of Health and the Centers for Disease Control and Prevention to study the impact of neonatal antibiotic exposures on the newborn and early childhood microbiome, and on infant and early childhood growth.  Dr. Puopolo is a member of the American Academy of Pediatrics Committee on the Fetus and Newborn, and is lead author of the Academy’s revised management guidelines for prevention and management of neonatal GBS disease. ​
Marti Perhach
7/22/2019 09:34:28 pm

Thank you, Dr. Puopolo, for all of your and your team's good work in updating the guidelines for GBS. Appreciate learning about the key changes from your presentation!

Diana Dunsmore
7/23/2019 06:55:42 am

Thank you Dr. Puopolo for a very informative presentation.
I have a question regarding the efficacy of Vanomycin compared to Penecillin? I am wondering why it is not considered adequate GBS IAP for purposes of neonatal risk assessment? I am a layman GBS grandmother, so a simple answer is sufficient. Thank you, Diana

Karen Puopolo
7/24/2019 12:09:26 pm

Dear Diana: Excellent question. First, vancomycin does not reliably cross the placenta and get to the baby. The new ACOG guidelines are endorsing different dosing recommendations that might make that issue better, or at least more consistent. Second, the way vancomycin works as an antibiotic, it does not kill GBS as quickly and thoroughly as penicillin-type antibiotics. Finally, as pediatricians, when we assess what to do with the baby, we want to make the safest, most conservative judgement so given these factors - we cannot assume vancomycin given to the mother is just as good as penicillin. I hope that clarifies things.

Efe Obasohan
7/23/2019 07:58:52 am

Thanks Dr. Puopolo for your presentation. Ampicillin remain a feasible alternative from the recommendations and readily available especially in developing countries. My concern is the possibility of resistance.

Karen Puopolo
7/24/2019 12:10:52 pm

Dear Dr. Obasohan: There are rare reports of GBS that are not fully susceptible to beta-lactam antibiotics such as ampicillin. Thankfully most GBS remains very susceptible to ampicillin and penicillin. You are right though that it could become a concern in the future.

Louisa Sandoval
7/23/2019 01:47:25 pm

Happy to see that women with previous colonization and a current unknown status can be considered for IAP!

Jerome P.
7/25/2019 09:46:27 am

Thank you for your helpful presentation on the key updates. I thought this study https://academic.oup.com/ije/article/33/1/107/668109 from the UK was very interesting in regards to gestation varying by ethnic group. Do you think this should be an area to be studied in the US to possibly guide future GBS care revisions?


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  • Home
  • About GBS
    • What Is Group B Strep? >
      • Prenatal-onset GBS Disease
      • Early-onset GBS Disease
      • Late-onset GBS Disease
      • GBS in Nonpregnant Adults
      • Maternal GBS Infections
    • How to Help Protect Your Baby >
      • How Do You Get GBS?
      • GBS Testing
      • Testing Negative
      • Subsequent Pregnancy
      • Risk Factors
    • Signs of GBS Infection
    • GBS Vaccine Efforts
  • Resources
    • GBS Awareness Materials
    • Online Learning Events >
      • GBS Community Days 2023
      • ICGBS 2022
      • ICGBS 2021
      • ICGBS 2020
      • ICGBS 2019
      • Prenatal Infection Prevention Symposium
      • POGBSD Symposium
    • Prenatal Infection Prevention Resources
    • GBS Medical Articles and Abstracts
    • GBS Parent Connection & Grief Support
  • Parent Stories
    • GBS Babies
    • Story Submission
    • Subsequent Pregnancies
    • Possible GBS Infections
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  • WAYS TO HELP
    • Make a Donation
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    • The WAVES Study
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    • Awareness Calendar >
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      • Prenatal Infection Prevention Month
    • Suggested Topics for Researchers
  • About Us
    • Our Mission
    • Our Board of Directors
    • Our Partners & Perinatal Health Affiliates
    • Fast Facts
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