title: Group B Streptococcal sepsis: an old or ongoing threat?
abstract: BACKGROUND
  Group B Streptococcus (GBS) is a major cause of severe infections in newborns. Early-onset disease (EOD) occurs within the first week of life, and it is usually vertically transmitted. In late-onset disease (LOD), pathogens may also come from nosocomial sources. We report 3 cases of GBS infection in very low birth weight infants hospitalized by a neonatal intensive care unit (NICU) in Italy.
  
  
  METHODS
  The cluster was identified thanks to an active surveillance program; an epidemiologic investigation took place. Pulsed-field gel electrophoresis (PFGE) was used to assess the clonal relatedness of strains. An audit to stress the adherence to isolation precautions and hand hygiene was organized.
  
  
  RESULTS
  During a 16-day period, 2 preterm newborns developed GBS LOD; an earlier case of GBS EOD occurred in a baby hospitalized by the same ward. The 3 GBS strains had the same antibiotic susceptibility pattern. The PFGE profiles of the 2 cases of LOD are indistinguishable from each other and closely related with the case of EOD. Strict infection control measures were adopted.
  
  
  CONCLUSIONS
  The implementation of additional infection control measures was able to stop the diffusion of infection; however, clusters like this should remind us the ongoing threat of GBS for the small NICU patients.
authors.affiliation: Department of Biomedical Science, Section of Hygiene, Polytechnic University of the Marches, Ancona, Italy; Hospital Hygiene Service, AOU Ospedali Riuniti Ancona, Ancona, Italy. Electronic address: p.barbadoro@univpm.it.
authors.forename: Pamela
authors.initials: P
authors.lastname: Barbadoro
authors.affiliation: Department of Biomedical Science, Section of Hygiene, Polytechnic University of the Marches, Ancona, Italy.
authors.forename: Anna
authors.initials: A
authors.lastname: Marigliano
authors.affiliation: Hospital Hygiene Service, AOU Ospedali Riuniti Ancona, Ancona, Italy.
authors.forename: Sandra
authors.initials: S
authors.lastname: Savini
authors.affiliation: Department of Biomedical Science, Section of Hygiene, Polytechnic University of the Marches, Ancona, Italy; Hospital Hygiene Service, AOU Ospedali Riuniti Ancona, Ancona, Italy.
authors.forename: Marcello Mario
authors.initials: MM
authors.lastname: D'Errico
authors.affiliation: Department of Biomedical Science, Section of Hygiene, Polytechnic University of the Marches, Ancona, Italy; Hospital Hygiene Service, AOU Ospedali Riuniti Ancona, Ancona, Italy.
authors.forename: Emilia
authors.initials: E
authors.lastname: Prospero
mesh_terms: D000328:Adult; D017668:Age of Onset; D016470:Bacteremia; D003428:Cross Infection / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology / Q000635:transmission; D016521:Electrophoresis, Gel, Pulsed-Field; D005260:Female; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology; D019102:Infant, Very Low Birth Weight; D017053:Infection Control; D018445:Infectious Disease Transmission, Vertical; D007363:Intensive Care Units, Neonatal; D007558:Italy; D018805:Sepsis / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology / Q000635:transmission; D013290:Streptococcal Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology / Q000635:transmission; D013292:Streptococcus agalactiae / Q000145:classification / Q000235:genetics* / Q000302:isolation & purification