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Volume 27, Number 9—September 2021
CME ACTIVITY - Research

Maternal Carriage in Late-Onset Group B Streptococcus Disease, Italy

Alberto BerardiComments to Author , Caterina Spada, Roberta Creti, Cinzia Auriti, Lucia Gambini, Vittoria Rizzo, Mariagrazia Capretti, Nicola Laforgia, Irene Papa, Anna Tarocco, Angela Lanzoni, Giacomo Biasucci, Giancarlo Piccinini, Giovanna Nardella, Giuseppe Latorre, Daniele Merazzi, Laura Travan, Maria Letizia Bacchi Reggiani, Lorenza Baroni, Matilde Ciccia, Laura Lucaccioni, Lorenzo Iughetti, and Licia Lugli
Author affiliations: Azienda Ospedaliero–Universitaria Policlinico, Modena, Italy (A. Berardi, C. Spada, L. Lucaccioni, L. Iughetti, L. Lugli); Istituto Superiore di Sanità, Rome, Italy (R. Creti); Ospedale Pediatrico Bambino Gesù, Rome (C. Auriti); Azienda Ospedaliero-Universitaria Policlinico, Parma, Italy (L. Gambini); Ospedale Civile M. Bufalini, Cesena, Italy (V. Rizzo); Azienda Ospedaliero–Universitaria S. Orsola–Malpighi, Bologna, Italy (M. Capretti, M.L. Bacchi Reggiani); Ospedale Policlinico, Bari, Italy (N. Laforgia); Ospedale Infermi, Rimini, Italy (I. Papa); Azienda Ospedaliero–Universitaria S. Anna, Ferrara, Italy (A. Tarocco); Ospedale Santa Maria della Scaletta, Imola, Italy (A. Lanzoni); Ospedale G. da Saliceto, Piacenza, Italy (G. Biasucci); Ospedale Santa Maria Delle Croci, Ravenna, Italy (G. Piccinini); Azienda Ospedaliero–Universitaria Ospedali Riuniti, Foggia, Italy (G. Nardella); Ospedale F. Miulli, Acquaviva delle Fonti, Italy (G. Latorre); Ospedale Valduce, Como, Italy (D. Merazzi); I; RCCS Materno Infantile Burlo Garofolo, Trieste, Italy (L. Travan); Arcispedale Santa Maria Nuova, Reggio Emilia, Italy (L. Baroni); Ospedale Maggiore, Bologna (M. Ciccia)

Main Article

Table 1

Demographics and clinical data of neonates with late-onset group B Streptococcus disease, Italy*

Characteristic LOD cases in preterm neonates, n = 18† LOD cases in full-term neonates, n = 80 p value Total, N = 98
Median birthweight, g (IQR) 1,285 (987–1,800) 3,185 (2,898–3,518) NA 3,110 (2,570–3,425)
Gestational age at delivery, wks, median (IQR) 31.0 (27.0–33.0) 39.0 (38.0–40.0) NA 39 (38–40)
Vaginal delivery 4 (22.2) 56 (70.0) <0.01 60 (61.2)
Planned caesarean section 8 (44.4) 18 (22.5) 0.11 26 (26.5)
IAP exposure‡ 9 (50.0) 29 (36.3) 0.42 38 (38.8)
Age at onset, median, d (IQR) 33 (26–45) 27 (15–43) 0.08 29 (16–43)
Mechanical ventilation 7 (38.9) 4 (5.0) <0.01 11 (11.2)
Focal infection§ 0 6 (7.5) 0.51 6 (6.1)
Meningitis with or without sepsis¶ 8 (57.1) 32 (56.1) 0.82 40 (56.3·)
Brain lesions at discharge from hospital# 7 (38.9) 15 (18.8) 0.12 22 (22.4)
Death 1 (5.6) 1 (1.3) 0.81 2 (1.0)

*Values are no. (%) except as indicated. GBS, group B streptococcus; IAP, intrapartum antibiotic prophylaxis; IQR, interquartile range; LOD, late-onset disease; NA, not applicable. †14 were early to moderate and 4 were late preterm neonates. ‡IAP was adequate (ampicillin, penicillin, or cefazolin given >4 h before delivery) in 3/9 (33.3%) cases in preterm neonates and in 17/29 (58.6%) cases in full-term neonates. §GBS-positive blood culture result associated with focal signs outside the respiratory tract (cellulitis, arthritis, parotiditis, others) (10). ¶Percentage and significance were calculated based on findings from lumbar puncture (in preterm neonates, 14 cases; in full-term neonates, 57 cases). Meningitis was culture-proven in 36/40 cases. #Brain lesions were confirmed through ultrasound, magnetic resonance study, or both.

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Page created: July 15, 2021
Page updated: August 19, 2021
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