title: [Decreasing incidence of perinatal group B streptococcal disease (Barcelona 1994-2002). Relation with hospital prevention policies].
abstract: BACKGROUND
  To analyze the incidence of perinatal sepsis due to group B streptococcus (GBS) as related to compliance with recommendations for its prevention issued by the Catalan Societies for Obstetrics, for Pediatrics, and for Infectious Diseases and Clinical Microbiology in 1997.
  
  
  METHODS
  The study was conducted from 1994 to 2001 in 10 Barcelona-area hospitals, where 157,848 live infants were born.
  
  
  RESULTS
  GBS disease was diagnosed in 129 neonates. Incidence decreased by 86.1% over the study period, from 1.92 cases per 1000 live births in 1994 to 0.26 per 1000 in 2001 (p < 0.001). Changes in the characteristics of perinatal GBS disease were observed in the 18 cases diagnosed in the last 3 years, the time when prevention policies were operative. The incidence was lower (0.28 per 1000 vs. 1.19 for the previous 5 years, p <.00006), the proportion of mothers without risk factors was greater (77.8% vs. 55.9%, p 5 0.009), and premature neonates were not affected (0% vs. 12.6%, p 5 0.003); nevertheless, mortality was similar (5.5% vs. 4.5%, p 5 0.8). Among these 18 cases of sepsis, 9 can be considered failures inherent to the prevention policy and 9 failures of compliance. Only 3 hospitals had prevention policies in 1994, whereas all 10 used intrapartum prophylaxis based on screening results in 2001.
  
  
  CONCLUSIONS
  A substantial decrease in the incidence of perinatal GBS disease coinciding with the application of prevention measures for this pathology has been registered in 10 participating hospitals over the 1994-2001 period.
authors.affiliation: Servicio de Microbiología. Hospital Vall d'Hebron. Barcelona. Spain. anando@cs.vhebron.es
authors.forename: Antonia
authors.initials: A
authors.lastname: Andreu
authors.forename: Isabel
authors.initials: I
authors.lastname: Sanfeliu
authors.forename: Lluis
authors.initials: L
authors.lastname: Viñas
authors.forename: Margarita
authors.initials: M
authors.lastname: Barranco
authors.forename: Jordi
authors.initials: J
authors.lastname: Bosch
authors.forename: Eva
authors.initials: E
authors.lastname: Dopico
authors.forename: Celia
authors.initials: C
authors.lastname: Guardia
authors.forename: Teresa
authors.initials: T
authors.lastname: Juncosa
authors.forename: Josep
authors.initials: J
authors.lastname: Lite
authors.forename: Lurdes
authors.initials: L
authors.lastname: Matas
authors.forename: Ferrán
authors.initials: F
authors.lastname: Sánchez
authors.forename: Montse
authors.initials: M
authors.lastname: Sierr
mesh_terms: D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D024881:Drug Resistance, Bacterial; D005260:Female; D019983:Guideline Adherence; D006786:Hospitals, Urban / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical; D008297:Male; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000382:microbiology; D012007:Rectum / Q000382:microbiology; D012307:Risk Factors; D018805:Sepsis / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control; D013030:Spain / Q000453:epidemiology; D013290:Streptococcal Infections / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control / Q000635:transmission; D013292:Streptococcus agalactiae / Q000276:immunology / Q000302:isolation & purification; D014621:Vagina / Q000382:microbiology
chemical_list: D000900:Anti-Bacterial Agents