title: Intrapartum antibiotic prophylaxis failure and group-B streptococcus early-onset disease.
abstract: OBJECTIVE
  To determine factors influencing intrapartum antibiotic prophylaxis (IAP) failure in the prevention of group B streptococcus (GBS) early-onset disease (EOD).
  
  
  METHODS
  GBS EOD case is defined as isolation of GBS from a normally sterile body site (e.g. blood or cerebrospinal fluid) in infants aged ≤7 days. During a consecutive 93-month period, GBS EOD cases and care data were reviewed.
  
  
  RESULTS
  Seventy-nine GBS EOD cases were registered; 67 infants were born to women who received no i.v. antibiotics during labor. The 12 EOD cases exposed to IAP were more likely to be associated with emergency caesarean section (p = 0.0015), maternal obstetric risk factors (ORFs) (p = 0.0061), particularly intrapartum fever (p = 0.0002), and to present with signs of illness at birth (p = 0.0015). Correct dosages, agents, and timing were registered in three cases only; of which two were associated with intrapartum fever.
  
  
  CONCLUSIONS
  ORFs, emergency caesarean section, and signs of illness at birth are significantly associated with GBS EOD in infants exposed to IAP. This study also suggests that recommended IAP agents, dosages, and timing are infrequently associated with EOD. Strict protocol adherence is recommended in all cases.
authors.affiliation: Azienda Ospedaliero-Universitaria Policlinico, Scienze Ostetriche, Ginecologiche e Pediatriche, Modena, Italy. berardi.alberto@policlinico.mo.it
authors.forename: Alberto
authors.initials: A
authors.lastname: Berardi
authors.forename: Licia
authors.initials: L
authors.lastname: Lugli
authors.forename: Cecilia
authors.initials: C
authors.lastname: Rossi
authors.forename: Mariachiara
authors.initials: M
authors.lastname: China
authors.forename: Claudio
authors.initials: C
authors.lastname: Chiossi
authors.forename: Lucia
authors.initials: L
authors.lastname: Gambini
authors.forename: Battista
authors.initials: B
authors.lastname: Guidi
authors.forename: Maria Federica
authors.initials: MF
authors.lastname: Pedna
authors.forename: Marina
authors.initials: M
authors.lastname: Piepoli
authors.forename: Angela
authors.initials: A
authors.lastname: Simoni
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Ferrari
mesh_terms: D000667:Ampicillin / Q000627:therapeutic use*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000453:epidemiology / Q000382:microbiology / Q000517:prevention & control; D007558:Italy / Q000453:epidemiology; D011247:Pregnancy; D011446:Prospective Studies; D013290:Streptococcal Infections / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control; D013292:Streptococcus agalactiae; D017211:Treatment Failure
chemical_list: D000900:Anti-Bacterial Agents; D000667:Ampicillin