title: Universal antenatal screening for group B streptococcus in Emilia-Romagna.
abstract: BACKGROUND
  Group B streptococcus (GBS) is a leading cause of severe infections in newborns. Intrapartum antibiotic chemoprophylaxis (IAP) reduces the rate of early-onset disease. The aim of this study is to determine the degree of clinicians' compliance with the suggested protocol for GBS prevention in Emilia-Romagna (Italy).
  
  
  METHODS
  Characteristics of each delivery were prospectively recorded in the period between October 2005 to December 2005. Standardized pro-forma were used to collect data.
  
  
  RESULTS
  Among 5118 babies, 7.2% (369) were preterm and 92.3% were born at term (4749). Antenatal screening was performed in 86.6% of women who delivered at term, of which 18.1% were GBS culture-positive. Information regarding culture site was available in 93.2% of women screened and recto-vaginal cultures were documented in 42.7%. IAP was administered to 28.7% of 3937 women at term who had either spontaneous delivery or emergency caesarean section. In this cohort, 15.9% were diagnosed GBS culture-positive, of which 92.6% received IAP. Prophylaxis was also administered to 8.4% (331) of women for no apparent reason. Compared with tertiary level hospitals, women delivering in primary/secondary hospitals were more likely to be both GBS screened (P < 0.0001; OR 3.04; CI 2.33-3.97) and to receive prophylaxis ≥4 hours before delivery (P = 0.0025; OR 1.57; CI 1.17-2.12).
  
  
  CONCLUSIONS
  GBS screening was performed in >85% of women and >90% of culture-positive women received prophylaxis. However, there is a need to educate clinicians about protocol adherence, as most cultures were suboptimal and cases of unnecessary IAP were administered. The screening was more effective in hospitals with fewer deliveries.
authors.affiliation: Unità Operativa di Terapia Intensiva Neonatale, Azienda Ospedaliero-Universitaria Policlinico di Modena, Via del Pozzo, 71-41100 Modena (MO), Italy. berardi.alberto@policlinico.mo.it
authors.forename: Alberto
authors.initials: A
authors.lastname: Berardi
authors.forename: Giorgia
authors.initials: G
authors.lastname: Di Fazzio
authors.forename: Sara
authors.initials: S
authors.lastname: Gavioli
authors.forename: Ezio
authors.initials: E
authors.lastname: Di Grande
authors.forename: Alessandra
authors.initials: A
authors.lastname: Groppi
authors.forename: Irene
authors.initials: I
authors.lastname: Papa
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Piccinini
authors.forename: Angela
authors.initials: A
authors.lastname: Simoni
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Tridapalli
authors.forename: Alessandro
authors.initials: A
authors.lastname: Volta
authors.forename: Fabio
authors.initials: F
authors.lastname: Facchinetti
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Ferrari
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007558:Italy; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data; D011247:Pregnancy; D011296:Prenatal Diagnosis / Q000706:statistics & numerical data*; D013290:Streptococcal Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D013292:Streptococcus agalactiae / Q000187:drug effects / Q000472:pathogenicity*
chemical_list: D000900:Anti-Bacterial Agents