title: [Group B streptococcal early-onset neonatal sepsis in the area of Barcelona (2004-2010). Analysis of missed opportunities for prevention].
abstract: OBJECTIVE
  To study the evolution of the incidence of early-onset neonatal sepsis (EOS) by Streptococcus agalactiae in the area of Barcelona and to analyze failure of compliance with the prevention protocol.
  
  
  METHODS
  A retrospective review was carried out on EOS cases in 8 Health-Care Centers in the Barcelona area between 2004 and 2010.
  
  
  RESULTS
  Forty-nine newborns from 48 mothers were diagnosed with EOS. The incidence was 0.29‰ living newborns (0.18-0.47‰), with no significant differences in the fluctuations along the 7 years. The mortality rate was 8.16%. In 68.5% cases the maternal colonization studies were negative, and in 21% these studies were not performed. No risk factors were detected in 58.3% of pregnant women, and 22.9% of births were premature. In 58% of cases intra-partum antibiotic prophylaxis was not administered because it was not indicated, and in 42% due to failure to follow the protocol (3 strains were resistant to erythromycin). Resistance to clindamycin was 33.3%. The Streptococcus agalactiae serotypes more frequently isolated were iii, v, and ia.
  
  
  CONCLUSIONS
  No significant changes were detected in the incidence of Streptococcus agalactiae EOS in the 7 years of the study. The increased sensitivity of screening methods with the use of molecular techniques, the performance of susceptibility testing of strains isolated from pregnant women, and the improvement of communication between Health-Care Centers, can contribute to a better implementation of the protocol, as well as to reduce the incidence of EOS.
authors.affiliation: Servicio de Microbiología, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, España. Electronic address: mgimenez.germanstrias@gencat.cat.
authors.forename: Montserrat
authors.initials: M
authors.lastname: Giménez
authors.affiliation: Servicio de Microbiología, Corporació Sanitària Parc Taulí, Sabadell, Barcelona, España.
authors.forename: Isabel
authors.initials: I
authors.lastname: Sanfeliu
authors.affiliation: Servicio de Microbiología, Hospital de Barcelona, Barcelona, España.
authors.forename: Montserrat
authors.initials: M
authors.lastname: Sierra
authors.affiliation: Laboratori Clínic de L'Hospitalet, L'Hospitalet de Llobregat, Barcelona, España.
authors.forename: Eva
authors.initials: E
authors.lastname: Dopico
authors.affiliation: Servicio de Microbiología, Hospital Universitari Sant Joan de Déu, Esplugues de Llobregat, Barcelona, España.
authors.forename: Teresa
authors.initials: T
authors.lastname: Juncosa
authors.affiliation: Servicio de Microbiología, Hospital Vall d'Hebron, Barcelona, España.
authors.forename: Antonia
authors.initials: A
authors.lastname: Andreu
authors.affiliation: Laboratorio de Mirobiología, Hospital Universitario Mútua de Terrassa, Terrassa, Barcelona, España.
authors.forename: Josep
authors.initials: J
authors.lastname: Lite
authors.affiliation: Laboratori Barcelonès Nord i Vallès Oriental, Institut Català de la Salut, Badalona, Barcelona, España.
authors.forename: Cèlia
authors.initials: C
authors.lastname: Guardià
authors.affiliation: Servicio de Microbiología, Hospital de Sant Pau, Barcelona, España.
authors.forename: Ferran
authors.initials: F
authors.lastname: Sánchez
authors.affiliation: Servicio de Microbiología, Hospital Clínic, Barcelona, España.
authors.forename: Jordi
authors.initials: J
authors.lastname: Bosch
mesh_terms: D017668:Age of Onset; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use; D019072:Antibiotic Prophylaxis / Q000706:statistics & numerical data; D002585:Cesarean Section / Q000706:statistics & numerical data; D057210:Delayed Diagnosis; D036861:Delivery, Obstetric; D005188:False Negative Reactions; D005260:Female; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D000071074:Neonatal Sepsis / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D013290:Streptococcal Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control; D013292:Streptococcus agalactiae / Q000302:isolation & purification*; D014505:Urban Population
chemical_list: D000900:Anti-Bacterial Agents
keywords: Early-onset neonatal sepsis; Intra-partum chemoprophylaxis; Prevención; Prevention; Profilaxis intraparto; Sepsis neonatal precoz; Streptococcus agalactiae