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[Early neonatal manifestations of group B Streptococcus infection: case series and preventive strategy]
P Moscatelli1, M Bartolini, F Caprioli
1Divisione di Neonatologia, E.O. Ospedali Galliera, Genova, Italia.
Insights
Group B Streptococcus (GBS) screening in pregnant women identifies colonization, enabling early intervention to prevent severe neonatal infections and mortality. Prompt antibiotic therapy for colonized newborns significantly reduces GBS disease risk.
Area of Science:
- Obstetrics and Gynecology
- Neonatal Medicine
- Infectious Diseases
Background:
- Group B Streptococcus (GBS) is a leading cause of neonatal morbidity and mortality.
- Effective screening and intervention strategies are crucial for reducing GBS-related adverse outcomes in newborns.
Purpose of the Study:
- To determine the prevalence of GBS colonization in pregnant women and their neonates.
- To assess the incidence and clinical manifestations of early-onset GBS infection in newborns.
- To evaluate the impact of GBS colonization on neonatal health outcomes.
Main Methods:
- Maternal vaginal and rectal swabs were collected upon admission to the labor area.
- Neonatal throat swabs were obtained at birth, and throat and rectal swabs on days 4 and 6.
- Analysis of 14,248 mother/infant pairs to identify GBS colonization rates and infection incidence.
Main Results:
- GBS colonization rates were 7% in mothers and 1% in neonates.
- Six out of 569 colonized newborns developed early-onset GBS infection (2 respiratory, 4 meningitis).
- Severe outcomes included 3 fatal cases and 1 with severe neurologic impairment; prematurity was a risk factor in only two cases.
Conclusions:
- Bacteriological screening for GBS in pregnant women is important.
- Intrapartum antibiotic therapy is recommended for women with risk factors and colonized newborns.
- Early intervention in colonized newborns, particularly when acute phase reactants are positive, can mitigate severe GBS disease.
Abstract:
Group B Streptococcus (GBS) is, so far, one of the most important causes of neonatal morbidity and mortality. In order to elucidate the extent of this problem a screening for GBS has been performed on a group of pregnant women and their neonates. Maternal vaginal and rectal swabs were obtained on admission to the labor area. In these infants throat swabs at birth and throat and rectal swabs on day 4th and 6th were obtained. In the 14,248 pairs mother/infant examined, the rate of colonization was, respectively, 9 (7%) and 4 (1%). 6 among 569 colonized newborn show evidence of the early onset type infection (respiratory form: 2 cases; meningitic form: 4 cases). Fatal outcome and severe neurologic impairment were observed respectively in 3 and 1 patient. Risk factors (prematurity) were present only in two patients. In all cases clinic evidence was observed before that laboratory findings were disposable. The Authors remark the importance of the bacteriological screening in pregnancy, and of antibiotic therapy intrapartum in women with risk factors and in colonized newborn in the first hour of life when acute phase reactants are positive.