Abstract
Background Group B streptococcus (GBS) is a leading cause of neonatal early-onset infections (EOI). In USA infections decreased after adoption of prevention guidelines, while in Europe strategies are low-developed. We retrospectively investigated prevention strategies in an Italian area (35 000 live birth/year).
Method Twenty-eight birth-centres of Emilia-Romagna were asked to fulfil a questionnaire about prevention strategies adopted during the 2000 and 2003. We promoted periodical meetings to develop and share prevention guidelines. Management of pregnant women and newborns were analyzed.
Results: Fifteen and 27 centres participated to the study during 2000 and 2003 respectively. All centres used a screening-based approach. Eight (57,1 %) in 2000 and 19 (70.4%) centres in 2003 collected maternal swabs at the lower third of vagina; rectal cultures or selective broth media were not used in 2000. Fourteen centres (51.9%) used vagino-rectal swabs and 5 (18.5%) selective broth media in 2003. If intrapartum chemoprophylaxis (IAP) was inadequate, thirteen centres (92.8%) in 2000 screened neonatal colonization, most of them (78.6%) treating colonized infants with antibiotics. In 2003 a few centres assessed colonization (37%) and treated (29.6%) infants. In 2000 only two centres (14.3%) collected blood cultures in 'at risk' newborn, while sixteen centres (59.2 %) did in 2003. Changes were more prominent in centres participating since 2000.
Conclusion Knowledge of guidelines among professionals and health-care providers is a good tool to obtain changes in GBS policies. Screening of pregnant women and ascertainment of neonatal infection significantly improved, avoiding newborn over treatment.
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Berardi, A., Lugli, L., Rossi, K. et al. 32 GBS Prevention Policies in a North Italian Area. Pediatr Res 58, 359 (2005). https://doi.org/10.1203/00006450-200508000-00061
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DOI: https://doi.org/10.1203/00006450-200508000-00061