2 disease incidence was 0.49 cases per 1,000 live births [14]. Following the revised CDC recommendations in 2002, average early-onset disease incidence decreased to 0.33 cases per 1,000 live births [14]. The purpose of this retrospective study was to determine the screening rate for GBS, the incidence of maternal GBS colonization and early-onset neonatal GBS sepsis. In addition, we determined compliance with the CDC recom- mendation for the use of intrapartum antibiotic prophylaxis for GBS positive women in a private tertiary care hospital after the 2002 CDC recommendation for universal screening of pregnant women for GBS colonization. 2. Materials and Methods The study was conducted at The Woman’s Hospital of Texas (WHT), Kelsey-Seybold Clinic (KSC), and the Kelsey Research Foundation (KRF). The WHT is a private tertiary care hospital with private physicians, a level III nursery that accepts maternal-fetal transfers, and the only specialty hospital in Houston, Texas focused on the care of women and infants. Approximately 22% of all WHT deliveries each year are high risk. KSC is a large, multispecialty medical clinic with 300 physicians that serves an ethnically diverse population of over 400,000 patients at 18 locations in Houston, Texas. The KRF is a 501 (c) (3) nonproﬁt that collaborates with healthcare and research institutions in the Texas Medical Center to conduct health services research, provide patient education, and develop quality improvement initiatives. Since 1995, the KRF has maintained a database of clinical information from both WHT and KSC about the pregnancy experience of over 20,000 women at KSC. The database contains information describing the pregnancy experience and outcomes of mothers and infants who received care at WHT and KSC. Data for all (9) obstetricians at KSC who routinely performed deliveries at WHT are included in this study. The database was queried to identify the number of deliveries performed during the two-year period (January 1, 2003 through December 31, 2004). Outcome variables included the number and percentage of pregnant mothers screened for GBS, the GBS status of those women screened, the rate of intrapartum antibiotic usage, and the incidence of early-onset GBS sepsis. Sepsis is deﬁned as a positive blood or spinal culture, or both, in addition to the clinical signs and symptoms of infection. Demographic variables, including age, ethnicity, and insurance status, also were collected from the administrative database. Data was analyzed using Microsoft EXCEL and ACCESS (2003, version 11.6355.6360 SP1) software. Because this is a retrospective analysis, waiver of consent was approved by the Institutional Review Board of WHT. At 35 to 37 weeks gestation, a standard cotton aerobic bacterial culture swab was gently inserted into the lower third of the vagina and then in a single motion, the perineum was swabbed and the external anal sphincter was swabbed. The swab was then placed in Stuart’s transport medium and Infectious Diseases in Obstetrics and Gynecology sent to the laboratory at room temperature. All specimens were sent to a commercial laboratory as directed by patients’ insurance providers. A screening culture was completed on arrival in labor and delivery if pregnancies were <35 weeks. If GBS bacteriuria was diagnosed during a pregnancy, the patient was considered colonized and treated during labor as per the CDC guidelines [12]. All women who had GBS positive cultures were given antibiotic prophylaxis in labor as recommended by the CDC guidelines [12]. Mothers allergic to penicillin were treated according to 2002 CDC guidelines [12]. 3. Results For the two-year study period, 2,108 women delivered 2,135 infants. Of these 2,108 deliveries, 8% were less than 37 weeks gestation. The mean gestational age at delivery was 38 ± 2.31 weeks. There were 39 sets of twins (1.8%), 20 infant deaths (0.9%), and 171 (8%) premature deliveries. (Prematurity is deﬁned as infants born at a gestational age less than 37 weeks.) The population was 40% African-American, 25% Cau- casian, 28% Hispanic, 5% Asian, and 2% other. Approxi- mately 3% of the women in the sample were less than 18 years of age, 56% were 18–30 years of age, 39% were 31–40 years of age, and 2% were 41 or older. The majority (71%) of women were insured through an HMO, while 27% had coverage with a PPO, 2% with Medicaid, and fewer than 1% were self-insured. The demographics of mothers who were GBS positive, GBS negative or those receiving intrapartum antibiotic prophylaxis were comparable to the demographics of the study sample. Chi-square tests were performed and there were no statistical diﬀerences in the subgroups. Among the 2,108 mothers, 1,874 (89%) were screened for GBS and, of these, 1,322 (71%) tested negative and 552 (29%) tested positive for GBS. There were 231 (11%) of the 2,108 mothers with an unknown GBS status. Thirty-two (1.5%) of the 2,135 infants in the sample were evaluated for sepsis during their hospitalizations. The sepsis workup included a CBC, blood culture, and lumbar puncture for spinal ﬂuid analysis and culture. Gestational age for 21 (66%) of these infants with sepsis was <30 weeks, for 8 (25%), gestational age was 30 to 36.7 weeks, and for 3 (9%), gestational age was ≥37 weeks. These infants were cultured for sepsis at birth and received antibiotics until results were available. For the majority (30) of these infants, culture results were negative and antibiotics were discontinued. For the two culture positive infants, one had positive blood cultures for GBS and the other had positive blood cultures for coagulase negative staphylococci, and none had meningitis. Thirty-one of the 32 (97%) infants were admitted to the NICU and had admissions of more than 30 days. Of these infants, one developed GBS sepsis. Of the 1,322 mothers who tested negative for GBS, 346 (26%) received antibiotic prophylaxis. Of the 346 that received antibiotics, 314 (91%) received antibiotics for surgi- cal prophylaxis (C-section) and 32 (9%) received antibiotics for acute infection (chorioamnionitis, pyelonephritis, and