The chief medical officer requested the former Health Protection Agency (HPA) to explore whether a more accurate test for group B streptococcus (GBS) in pregnant women, called enriched culture medium (ECM), should be made available in its regional laboratories, when there was a clinical indication for testing.

In response to this, Public Health England (PHE, formerly the HPA) undertook a piece of work with clinical organisations to determine in which circumstances the ECM test could be used in pregnant women.

In the event, this work concluded that within current clinical guidance from the key professional bodies, UK National Screening Committee, the Royal College of Obstetricians and Gynaecologists and the National Institute for Health and Care Excellence, there are no clinical indications which should prompt the offer of an ECM test for GBS and so PHE decided not to provide this test in its laboratories.

PHE does not offer any testing exclusively for GBS in babies. When a neonate presents with symptoms consistent with a systemic infection—or sepsis—isolation of micro-organisms from blood cultures remains the gold standard method of diagnosing sepsis. Neonatal sepsis can be caused by GBS, but other important micro-organisms such as E.coli and Staphylococcus aureus can also cause sepsis, and blood culture is the most effective method of differentiating between these different types of bacteria.

Public Health England (PHE) understands that enriched culture medium (ECM) testing is available for women during pregnancy in some other countries including some European countries, the United States of America and Canada.

In the United Kingdom, the National Screening Committee (UK NSC) advises Ministers and the national health service in all four UK countries about all aspects of screening policy, including screening policy for group B streptococcus (GBS) carriage in pregnancy.

At its meeting in 2012 the UK NSC recommended that in the UK context, screening for GBS carriage at 35 to 37 weeks of pregnancy should not be offered. When reviewing the evidence for antenatal screening for GBS carriage, the UK NSC looked at evidence from a number of countries. A systematic review of the global prevalence of early and late onset GBS was reviewed. This suggested that the rate of infections in the UK was comparable to that in countries and regions employing widespread testing.

Within the English context, PHE undertook a piece of work with clinical organisations, including the Royal College of Obstetricians and Gynaecologists, to determine

whether there are any circumstances in which the ECM test could be applied within current accepted standards of care.

This work by PHE concluded that there are no clinical indications for testing women for GBS using ECM methods as recommended within current guidance from the key professional bodies.

There are currently no plans to introduce, the test because within current clinical guidance from the key professional bodies, the Royal College of Obstetricians and Gynaecologists or the National Institute for Health and Care Excellence, there are no clinical indications which should prompt the offer of an enriched culture medium test for group B streptococcus.

Should the clinical guidance change the situation would be reviewed.