Strategies for preventing group B streptococcal infections in newborns: a nation-wide survey of Italian policies

Tzialla, Chryssoula; Berardi, Alberto; Farina, Claudio; Clerici, Pierangelo; Borghesi, A.; Viora, E.; Scollo, Paolo; Stronati, Mauro

doi:10.1186/s13052-017-0409-1

Cited by 9 publications

(7 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…As preterm neonates younger than 34 weeks’ gestation need special care in NICUs, we focused on late preterm (34–36 weeks’ gestation) and full-term (≥37 weeks’ gestation) neonates, that account for over 90% of total deliveries and are managed in all birthing centers across country. The recent national survey [ 4 ] has shown that great resources are poored into prevention of EOS, and often are given unnecessary antibiotics. Ancillary laboratory tests currently available are low predictive for asymptomatic neonates and have insufficient accuracy for guiding the decision as to whether neonates should be treated with antibiotics [ 2 ].…”

Section: Discussionmentioning

confidence: 99%

“…The recent national survey [ 4 ] shows that the screening-based strategy is largely prevalent and protocols in most centers are consistent with the CDC guidelines [ 1 ]. However, differences in GBS EOS sepsis occur among Northern, Central and Southern regions.…”

Section: Main Textmentioning

confidence: 99%

“…However, differences in GBS EOS sepsis occur among Northern, Central and Southern regions. Furthermore, 75% of respondent neonatal units would obtain laboratory testing and 91% would administer empirical antibiotics to full-term and preterm neonates exposed to inadequate IAP, although asymptomatic [ 4 ]. This practice is not consistent with the CDC guidelines [ 1 ].…”

Section: Main Textmentioning

confidence: 99%

See 2 more Smart Citations

Secondary prevention of early-onset sepsis: a less invasive Italian approach for managing neonates at risk

et al. 2018

Self Cite

View full text Add to dashboard Cite

Strategies to prevent early-onset sepsis (EOS) have led to a substantial decline in many countries. However, one of the most controversial topics in neonatology is the management of asymptomatic full-term and late preterm neonates at risk for EOS, and guidelines lack substantial consensus regarding this issue. A strategy for managing neonates, entirely based on serial physical examinations, has been developed in two Italian regions. This strategy seems safe, while reducing laboratory tests and unnecessary antibiotics. In the current commentary we provide area-based data concerning the prevention of EOS in 2 northern Italian regions, and we detail the results of their strategy for managing healthy-appearing newborns at risk for EOS.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Main Textmentioning

confidence: 99%

Section: Main Textmentioning

confidence: 99%

See 1 more Smart Citation

Secondary prevention of early-onset sepsis: a less invasive Italian approach for managing neonates at risk

et al. 2018

Self Cite

View full text Add to dashboard Cite

show abstract

“…The EOGBS incidence at our hospitals was 0.38 per 1000 live births in the era of universal GBS screening, but this decline was not as dramatic as that observed in Western countries. 16,17 More than 60% of the EOGBS neonates were born to women with negative screening results. 1,18,19 Reasons for this missed opportunity for GBS prevention include serotype-specific colonization patterns and inadequate rectovaginal sampling.…”

Section: + Modelmentioning

confidence: 99%

An 18-year retrospective study on the epidemiology of early-onset neonatal sepsis - emergence of uncommon pathogens

Chang

et al. 2021

Pediatrics & Neonatology

View full text Add to dashboard Cite

Background: Nationwide group B Streptococcus agalactiae (GBS) antepartum screening was instituted in Taiwan in 2012. The impact of the policy on early-onset sepsis (EOS) has not been evaluated. This study aimed to examine the impact of the policy on the incidence of neonatal EOS. Methods: This was a retrospective study conducted at MacKay Children's Hospital. Patients with culture-proven neonatal EOS were enrolled and divided by birth year in relation to the implementation of GBS prevention policy: Epoch 1, 2001e2004 pre-GBS screening; Epoch 2, 2005e2011 elective GBS screening; and Epoch 3, 2012e2018 universal GBS screening. The pathogens and antimicrobial resistance patterns were reviewed and analyzed. The incidence was modeled using Poisson regression. Results: A total of 128 neonates met the enrollment criteria. The observed incidence of EOS was 1.52&. The incidence rates of EOS, GBS, and Escherichia coli (E. coli) sepsis were similar in Epoch 1 and Epoch 3. E. coli and non-Enterococcal group D Streptococcus (GDS) infection increased significantly in term infants, whereas the EOS-related mortality rate declined in preterm infants. Approximately 72% of the isolated E. coli were ampicillin-resistant, and the antimicrobial sensitivity remained unaltered during the studied period. Conclusions: The overall EOS incidence has not changed from 2001 to 2018. However, changes in the causative pathogens were observed in both term and preterm infants. Clinicians should be aware of this evolving epidemiology to provide prompt appropriate perinatal management.

show abstract

“…2,3 Moreover, there is a risk that the child may be colonized during delivery, which occasionally causes "early onset disease" (EOD), which is associated with PPROM. [3][4][5][6] Intrauterine infection is assumed to arise from vaginal bacteria that pass through the cervical canal, gain access to the decidua, and invade and cross the intact chorioamniotic membranes to access the amniotic cavity. 7 However, infections do not always elicit inflammatory responses or PPROM.…”

Section: Introductionmentioning

confidence: 99%

Streptococcus agalactiae do not penetrate human chorioamniotic membranes in vitro but alter their biomechanical properties

Mohamed

Hinge

Larsen

et al. 2021

Acta Obstet Gynecol Scand

View full text Add to dashboard Cite

Introduction: Vaginal colonization with Streptococcus agalactiae (group B streptococci) is hypothesized to constitute a risk factor for preterm prelabor rupture of membranes.In vitro studies have shown that S. agalactiae strains isolated from infants with neonatal sepsis adhere to chorion cells of the human chorioamniotic membrane. However, it is still unknown whether S. agalactiae strains penetrate the chorioamniotic membranes and whether S. agalactiae colonization affects the biomechanical properties of the membranes and thus contributes to increased risk of preterm prelabor rupture.The aim of this in vitro study was to explore if different strains of S. agalactiae penetrate and affect the biomechanical properties of human chorioamniotic membranes.Material and methods: Three different strains of S. agalactiae were obtained, one from an early-onset neonatal infection, one from a case of preterm prelabor rupture of membranes and one from a healthy pregnant carrier. Chorioamniotic membranes from elective cesarean deliveries were either incubated with S. agalactiae or mounted in a two-chamber incubation cell generating a "maternal" and a "fetal" chamber and incubated with S. agalactiae in the maternal chamber. Subsequently the membranes were examined to evaluate S. agalactiae attachment, penetration and the effect on the biomechanical properties. Results: At 5 h after incubation, S. agalactiae adhered to the chorioamniotic membranes with increased number at 20 h. Streptococcus agalactiae did not penetrate the membranes even after 20 h of incubation. Streptococcus agalactiae increased the ultimate tensile stress needed to rupture the membranes and increased the work needed to rupture the membranes as well as the elastic modulus. Conclusions: Human chorioamniotic membranes constitute a physical barrier against S. agalactiae infections. Moreover, S. agalactiae infection leads to increased strength of the membranes. K E Y W O R D S chorioamniotic membranes, fetal membranes, group B streptococcus, perinatal infections, preterm prelabor rupture of membranes, Streptococcus agalactiae, tensile testing | 1815 MOHAMED Et Al.

show abstract

Strategies for preventing group B streptococcal infections in newborns: a nation-wide survey of Italian policies

Cited by 9 publications

References 18 publications

Secondary prevention of early-onset sepsis: a less invasive Italian approach for managing neonates at risk

Secondary prevention of early-onset sepsis: a less invasive Italian approach for managing neonates at risk

An 18-year retrospective study on the epidemiology of early-onset neonatal sepsis - emergence of uncommon pathogens

Streptococcus agalactiae do not penetrate human chorioamniotic membranes in vitro but alter their biomechanical properties

Contact Info

Product

Resources

About