Universal Antenatal Screening for Group B Streptococcus in Emilia-romagna

Author:

Berardi Alberto1,Di Fazzio Giorgia2,Gavioli Sara2,Di Grande Ezio3,Groppi Alessandra4,Papa Irene5,Piccinini Giancarlo6,Simoni Angela7,Tridapalli Elisabetta8,Volta Alessandro9,Facchinetti Fabio10,Ferrari Fabrizio11

Affiliation:

1. Consultant Neonatologist, Unità Operativa di Terapia Intensiva Neonatale, Azienda Ospedaliero-Universitaria Policlinico di Modena, Italy

2. Paediatric Trainee, Unità Operativa di Terapia Intensiva Neonatale, Azienda Ospedaliero-Universitaria Policlinico di Modena, Italy

3. Consultant Paediatrician, Unità Operativa di Pediatria, Ospedale Civile di Sassuolo, Italy

4. Consultant Paediatrician, Unità Operativa di Pediatria, Ospedale Civile di Pavullo, Italy

5. Consultant Neonatologist, Unità Operativa di Terapia Intensiva Neonatale, Ospedale Infermi di Rimini, Italy

6. Consultant Paediatrician, Unità Operativa di Terapia Intensiva Neonatale, Ospedale Santa Maria delle Croci di Ravenna, Italy

7. Consultant Paediatrician, Unità Operativa di Pediatria, Ospedale B Ramazzini di Carpi, Italy

8. Consultant Neonatologist, Unità Operativa di Terapia Intensiva Neonatale, Azienda Ospedaliero-Universitaria S. Orsola di Bologna, Italy

9. Consultant Paediatrician, Nido, Ospedale Franchini di Montecchio, Italy

10. Consultant Obstetrician, Unità Operativa di Ostetricia, Azienda Ospedaliero-Universitaria Policlinico di Modena, Italy

11. Neonatal Intensive Care Unit, Unità Operativa di Terapia Intensiva Neonatale, Azienda Ospedaliero-Universitaria Policlinico di Modena, Italy

Abstract

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 proforma 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.

Publisher

SAGE Publications

Subject

Public Health, Environmental and Occupational Health,Health Policy

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