Risk factors for group B streptococcus early-onset disease: an Italian, area-based, case-control study

Berardi, Alberto; Spada, C.; Creti, Roberta; Ambretti, Simone; Chiarabini, Rossana; Barozzi, Agostino; Pagano, Rossella; Sarti, Mario; Pedna, Maria Federica; Fornaciari, Sara; Azzalli, Milena; Dodi, Icilio; Reggiani, Maria Letizia Bacchi; Lanzoni, Angela; Vaccina, Eleonora; Lucaccioni, Laura

doi:10.1080/14767058.2019.1628943

Cited by 4 publications

(2 citation statements)

References 21 publications

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“…In Italy, late third-trimester antenatal screening and IAP are recommended to lower the risk of GBS-EOD [18]. There are not national data on the incidence of neonatal invasive GBS disease; nevertheless, regional area-based studies have reported a sharp decline in the incidence of EOD after the implementation of targeted intravenous IAP [19][20][21][22][23].…”

Section: Introductionmentioning

confidence: 99%

Invasive Group B Streptococcal Disease in Neonates and Infants, Italy, Years 2015–2019

et al. 2021

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Invasive infections by group B streptococci (iGBS) are the leading cause of sepsis and meningitis in the first three months of life worldwide. The clinical and microbiological characteristics of neonatal and infant iGBS in Italy during the years 2015–2019 were investigated. Voluntary-based surveillance reported 191 cases (67 early-onset (EOD) and 124 late-onset disease (LOD)) and 89 bacterial isolates were received. The main clinical manifestations were sepsis (59.2%) followed by meningitis (21.5%), bacteremia (12.0%) and septic shock (6.3%). Hospitalized preterm babies accounted for one third of iGBS and constituted the most fragile population in terms of mortality (8.2%) and brain damage (16.4%). GBS serotype III was predominant in EOD (56%) and caused almost all LOD (95%). The rate of resistance to clindamycin reached 28.8%. Most of clindamycin-resistant GBS strains (76%) were serotype III-ST17 and possessed the genetic markers of the emerging multidrug resistant (MDR) CC-17 sub-clone. Our data revealed that iGBS is changing since it is increasingly reported as a healthcare-associated infection (22.6%), mainly caused by MDR-CC17. Continuous monitoring of the clinical and microbiological characteristics of iGBS remains of primary importance and it represents, at present, the most effective tool to support prevention strategies and the research on the developing GBS vaccine.

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Section: Introductionmentioning

confidence: 99%

Invasive Group B Streptococcal Disease in Neonates and Infants, Italy, Years 2015–2019

et al. 2021

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“…Extending the SPE approach to the entire newborn population can reduce missed diagnoses. Berardi et al showed that the universal SPE approach could produce a sharp reduction in laboratory exams and antibiotic treatments without a consequent increase in EOS [ 34 , 44 ].…”

Section: Discussionmentioning

confidence: 99%

Neonatal Early Onset Sepsis (EOS) Calculator plus Universal Serial Physical Examination (SPE): A Prospective Two-Step Implementation of a Neonatal EOS Prevention Protocol for Reduction of Sepsis Workup and Antibiotic Treatment

et al. 2022

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Current neonatal early-onset sepsis (EOS) guidelines lack consensus. Recent studies suggest three different options for EOS risk assessment among infants born ≥35 wks gestational age (GA), leading to different behaviors in the sepsis workup and antibiotic administration. A broad disparity in clinical practice is found in Neonatal Units, with a large number of non-infected newborns evaluated and treated for EOS. Broad spectrum antibiotics in early life may induce different short- and long-term adverse effects, longer hospitalization, and early mother-child separation. In this single-center prospective study, a total of 3002 neonates born in three periods between 2016 and 2020 were studied, and three different workup algorithms were compared: the first one was based on the categorical risk assessment; the second one was based on a Serial Physical Examination (SPE) strategy for infants with EOS risk factors; the third one associated an informatic tool (Neonatal EOS calculator) with a universal extension of the SPE strategy. The main objective of this study was to reduce the number of neonatal sepsis workups and the rate of antibiotic administration and favor rooming-in and mother–infant bonding without increasing the risk of sepsis and mortality. The combined strategy of universal SPE with the EOS Calculator showed a significant reduction of laboratory tests (from 33% to 6.6%; p < 0.01) and antibiotic treatments (from 8.5% to 1.4%; p < 0.01) in term and near-term newborns. EOS and mortality did not change significantly during the study period.

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Impact of antimicrobial stewardship interventions on peripartum antibiotic prescribing in patients with penicillin allergy

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et al. 2023

American Journal of Obstetrics & Gynecology MFM

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Risk factors for group B streptococcus early-onset disease: an Italian, area-based, case-control study

Cited by 4 publications

References 21 publications

Invasive Group B Streptococcal Disease in Neonates and Infants, Italy, Years 2015–2019

Invasive Group B Streptococcal Disease in Neonates and Infants, Italy, Years 2015–2019

Neonatal Early Onset Sepsis (EOS) Calculator plus Universal Serial Physical Examination (SPE): A Prospective Two-Step Implementation of a Neonatal EOS Prevention Protocol for Reduction of Sepsis Workup and Antibiotic Treatment

Impact of antimicrobial stewardship interventions on peripartum antibiotic prescribing in patients with penicillin allergy

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