4 A major strength of this study is our ability to capture data on GBS screening and usage of intrapartum antibiotic prophylaxis from our obstetrical database. Similar surveil- lance studies conducted by the CDC have been limited due to their inability to measure health care provider compliance with screening guidelines [14]. Despite our high rate of GBS screening, 11% of mothers had unknown GBS status at delivery. However, more than two-thirds of these women received prophylaxis for GBS based on risk factors alone. An additional strength is that the results reﬂect the management of GBS in a private tertiary care nonteaching obstetrical unit, with 80 practicing obstetricians, versus an academic hospital. The widely diverse nonhomogeneous patient population speaks to the nondiscriminatory nature of GBS colonization. The retrospective nature of the study may be a weakness because the study sample was not controlled and was limited to a small proportion of the total deliveries at WHT. However, the study sample did represent 42% of all KSC deliveries during the two-year study period. Another weakness is that there were 11% (231) of moth- ers that were either not screened or data were not available. If a GBS positive rate of 29% is used, then this would contribute an additional 70 women to the GBS positive group. A confounding ﬁnding was that there were three newborns who developed early-onset GBS sepsis born to GBS positive mothers that were administered appropriate intrapartum antibiotic prophylaxis. It is not known whether or not GBS amnionitis was present at the time of admission to labor and delivery. None of these women had clinical signs or symptoms of infection. This emphasizes the fact that universal screening and intrapartum antibiotic prophylaxis cannot eliminate the occurrence of neonatal early-onset GBS sepsis. Based on our experience reviewing GBS in mothers, we have undertaken an extensive review of neonatal outcomes in newborns of mothers receiving antibiotic prophylaxis within 4 hours of delivery. We also are developing a study to determine whether rapid screening using the PCR method in untested and GBS negative mothers will further reduce GBS infection in newborns. 5. Conclusion This study found that adherence to the 2002 CDC guidelines for screening and prophylaxis for GBS could readily be accepted, and that in the ﬁrst year of implementation, 89% of women delivering in a private tertiary care hospital with a large number of practicing obstetricians were screened. This retrospective study demonstrated that universal screening for GBS is eﬀective and can be achieved in a private tertiary care hospital. Acknowledgments This research was funded by The Woman’s Hospital of Texas and the Kelsey Research Foundation. 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