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Updated: May 30, 2026
A Murine Model of Group B Streptococcus Vaginal Colonization
Published on: November 16, 2016
Universal antenatal screening for group B streptococcus in Emilia-Romagna
Alberto Berardi1, Giorgia Di Fazzio, Sara Gavioli
1Unità Operativa di Terapia Intensiva Neonatale, Azienda Ospedaliero-Universitaria Policlinico di Modena, Via del Pozzo, 71-41100 Modena (MO), Italy. berardi.alberto@policlinico.mo.it
Insights
Group B Streptococcus (GBS) screening exceeded 85% in pregnant women, with over 90% of positive cases receiving intrapartum antibiotic chemoprophylaxis (IAP). However, suboptimal cultures and unnecessary IAP indicate a need for improved clinician education on GBS prevention protocols.
Area of Science:
- Obstetrics and Gynecology
- Neonatal Infectious Diseases
- Public Health
Background:
- Group B Streptococcus (GBS) is a primary cause of neonatal infections.
- Intrapartum antibiotic chemoprophylaxis (IAP) is crucial for preventing early-onset GBS disease.
- Assessing adherence to GBS prevention protocols is vital for maternal and infant health.
Purpose of the Study:
- To evaluate clinician compliance with GBS prevention protocols in Emilia-Romagna, Italy.
- To identify areas for improvement in GBS screening and prophylaxis administration.
- To analyze factors influencing screening and prophylaxis rates in different hospital settings.
Main Methods:
- Prospective data collection on deliveries from October to December 2005.
- Utilized standardized pro-forma for recording delivery characteristics.
- Analyzed data on antenatal screening, GBS culture results, and IAP administration.
Main Results:
- Antenatal GBS screening was performed in 86.6% of women delivering at term, with 18.1% testing positive.
- Recto-vaginal cultures were documented in only 42.7% of screened women.
- IAP was administered to 28.7% of women at term, including 15.9% who were GBS culture-positive and 8.4% without clear indication.
Conclusions:
- While GBS screening rates were high (>85%), culture quality was often suboptimal.
- Over 90% of GBS culture-positive women received prophylaxis, but unnecessary IAP occurred in 8.4% of cases.
- GBS screening was more effective in hospitals with lower delivery volumes, suggesting a need for protocol education and standardization.
Background:
Group B streptococcus (GBS) is a leading cause of severe infections in newborns. Intrapartum antibiotic chemoprophylaxis (IAP) reduces the rate of early-onset disease. The aim of this study is to determine the degree of clinicians' compliance with the suggested protocol for GBS prevention in Emilia-Romagna (Italy).
Methods:
Characteristics of each delivery were prospectively recorded in the period between October 2005 to December 2005. Standardized pro-forma were used to collect data.
Results:
Among 5118 babies, 7.2% (369) were preterm and 92.3% were born at term (4749). Antenatal screening was performed in 86.6% of women who delivered at term, of which 18.1% were GBS culture-positive. Information regarding culture site was available in 93.2% of women screened and recto-vaginal cultures were documented in 42.7%. IAP was administered to 28.7% of 3937 women at term who had either spontaneous delivery or emergency caesarean section. In this cohort, 15.9% were diagnosed GBS culture-positive, of which 92.6% received IAP. Prophylaxis was also administered to 8.4% (331) of women for no apparent reason. Compared with tertiary level hospitals, women delivering in primary/secondary hospitals were more likely to be both GBS screened (P < 0.0001; OR 3.04; CI 2.33-3.97) and to receive prophylaxis ≥4 hours before delivery (P = 0.0025; OR 1.57; CI 1.17-2.12).
Conclusions:
GBS screening was performed in >85% of women and >90% of culture-positive women received prophylaxis. However, there is a need to educate clinicians about protocol adherence, as most cultures were suboptimal and cases of unnecessary IAP were administered. The screening was more effective in hospitals with fewer deliveries.
