TY - JOUR
T1 - Group B Streptococcus early-onset disease and observation of well-appearing newborns
AU - GBS Prevention Working Group of Emilia-Romagna
AU - Berardi, Alberto
AU - Spada, Caterina
AU - Reggiani, Maria Letizia Bacchi
AU - Creti, Roberta
AU - Baroni, Lorenza
AU - Capretti, Maria Grazia
AU - Ciccia, Matilde
AU - Fiorini, V.
AU - Gambini, Lucia
AU - Gargano, Giancarlo
AU - Papa, Irene
AU - Piccinini, Giancarlo
AU - Rizzo, Vittoria
AU - Sandri, Fabrizio
AU - Lucaccioni, Laura
AU - Benitz, William
AU - Alto, Palo
AU - Memo, L.
AU - Nicolini, G.
AU - Ciccia, M.
AU - Bastelli, A.
AU - Sandri, F.
AU - Ambretti, S.
AU - Capretti, M. G.
AU - Corvaglia, L.
AU - Dondi, A.
AU - Lanari, M.
AU - Pasini, L.
AU - Ragni, L.
AU - Albarelli, A.
AU - Fiorini, V.
AU - Giugno, C.
AU - Lanzoni, P.
AU - Di Grande, E.
AU - Polese, A.
AU - China, M. C.
AU - Rizzo, Vittoria
AU - Stella, M.
AU - Zucchini, A.
AU - Serra, L.
AU - Berardi, A.
AU - Facchinetti, F.
AU - Ferrari, F.
AU - Muratori, C.
AU - Carretto, E.
AU - Gargano, G.
AU - Riva, M.
AU - Ancona, G.
AU - Bonvicini, C.
AU - Palmieri, R.
PY - 2019/3/20
Y1 - 2019/3/20
N2 - Background International guidelines lack a substantial consensus regarding management of asymptomatic full-term and late preterm neonates at risk for early-onset disease (EOS). Large cohorts of newborns are suitable to increase the understanding of the safety and efficacy of a given strategy. Methods This is a prospective, area-based, cohort study involving regional birth facilities of Emilia-Romagna (Italy). We compared cases of EOS (at or above 35 weeks' gestation) registered in 2003-2009 (baseline period: 266,646 LBs) and in 2010-2016, after introduction of a new strategy (serial physical examinations, SPEs) for managing asymptomatic neonates at risk for EOS (intervention period: 265,508 LBs). Results There were 108 cases of EOS (baseline period, n = 60; intervention period, n = 48). Twenty-two (20.4 remained asymptomatic through the first 72 hours of life, whereas 86 (79.6 developed symptoms, in most cases (52/86, 60.5 at birth or within 6 hours. The median age at presentation was significantly earlier in the intrapartum antibiotic prophylaxis (IAP)-exposed than in the IAP-unexposed neonates (0 hours, IQR 0.0000-0.0000 vs 6 hours, IQR 0.0000-15.0000, p
AB - Background International guidelines lack a substantial consensus regarding management of asymptomatic full-term and late preterm neonates at risk for early-onset disease (EOS). Large cohorts of newborns are suitable to increase the understanding of the safety and efficacy of a given strategy. Methods This is a prospective, area-based, cohort study involving regional birth facilities of Emilia-Romagna (Italy). We compared cases of EOS (at or above 35 weeks' gestation) registered in 2003-2009 (baseline period: 266,646 LBs) and in 2010-2016, after introduction of a new strategy (serial physical examinations, SPEs) for managing asymptomatic neonates at risk for EOS (intervention period: 265,508 LBs). Results There were 108 cases of EOS (baseline period, n = 60; intervention period, n = 48). Twenty-two (20.4 remained asymptomatic through the first 72 hours of life, whereas 86 (79.6 developed symptoms, in most cases (52/86, 60.5 at birth or within 6 hours. The median age at presentation was significantly earlier in the intrapartum antibiotic prophylaxis (IAP)-exposed than in the IAP-unexposed neonates (0 hours, IQR 0.0000-0.0000 vs 6 hours, IQR 0.0000-15.0000, p
KW - Streptococcal infection
KW - Newborn
KW - Group B streptococcus
U2 - 10.1371/journal.pone.0212784
DO - 10.1371/journal.pone.0212784
M3 - Article
VL - 14
JO - PLoS One
JF - PLoS One
SN - 1932-6203
IS - 3
ER -