Neonatal Group B streptococcal infection in a North Italian area

Background Group B streptococcus (GBS) is the leading cause of early-onset infections (EOI) in the developed world. Few data are available in Europe about incidence and clinical findings of neonatal disease. We reviewed cases occurred in the last 2 years in Emilia-Romagna (an area with about 4 500 000 million people).Methods Neonatal, pediatric departments and laboratories fulfilled a chart for any case of disease observed during 2003 and 2004. GBS was recovered in blood or cerebrospinal fluid (CSF). Prenatal screening, risk factors, intrapartum chemoprophylaxis (IAP) and clinical findings were analysed.Results: We observed 21 EOI and 13 late onset (LOI). Incidence was 0.56 and 0.38/1.000 live birth in 2003 and 2004 respectively. Mortality was 12,5% (1 EOI and 3 LOI). Among 21 EOI, 7 were bacteraemia, 12 sepsis and 2 meningitis. CSF was not collected in 8/14 symptomatic infants. Six mothers were vaginally colonized; 13/21 were negative and 2 unscreened; 5/21 had one or more risk factors. Only 2 (suspected chorioamnionitis) received a complete IAP, while 19/21 were untreated. Among 13 LOI, 3/13 mothers were colonized and 5/13 had 1 or more risk factors. LOI were: 5 sepsis, 7 meningitis and 1 focal infection. CSF was not collected in 5/13.Conclusion: Incidence of GBS infection was similar to that currently reported in US. Most EOI (90.5%) had no prophylaxis. Risk factors were detected in 23.8 % of EOI (GBS bacteriuria was not routinely screened). Meningitis was diagnosed in 33.3 % symptomatic infants, but CSF analysis was not performed in 48.1% cases. More efforts are needed to improve prophylaxis strategies.