title: Screening and management of maternal colonization with Streptococcus agalactiae: an Italian cohort study.
abstract: BACKGROUND
  Streptococcus agalactiae (Group B streptococcus [GBS]) is the most common cause of sepsis and meningitis in infants <3 months of age. Intrapartum antibiotic prophylaxis (IAP) is effective in preventing the transmission of GBS to newborns. The Centers for Disease Control and Prevention (CDC) guidelines suggest vaginal and rectal cultures to assess GBS colonization between 35 and 37 weeks' gestation.
  
  
  METHODS
  Between July and December 2013, we identified 535 women admitted to the Obstetric and Gynecology Unit of Cardarelli Hospital (Campobasso, Italy) for delivery. We evaluated the indications for IAP, complete execution of IAP, and neonatal outcomes.
  
  
  RESULTS
  Our sample included 468 women and 475 live births. Correct screening for GBS was executed in 241 cases (51.5%), the number of women colonized was 96 (30.2%), and 136 women had indications to receive IAP, but only 68 (50%) received adequate treatment.
  
  
  CONCLUSIONS
  GBS colonization status should be determined by collecting both vaginal and rectal specimens at 35-37 weeks' gestation. Inadequate screening for GBS and incorrect IAP led to an increased incidence of early-onset disease in newborns. Local public health agencies should promote surveillance and educational programs to prevent neonatal GBS infections.
authors.affiliation: a Department of Obstetrics and Gynaecology , Policlinico A. Gemelli, Catholic University of Sacred Heart , Rome , Italy .
authors.forename: Carmen
authors.initials: C
authors.lastname: De Luca
authors.affiliation: a Department of Obstetrics and Gynaecology , Policlinico A. Gemelli, Catholic University of Sacred Heart , Rome , Italy .
authors.forename: Natalina
authors.initials: N
authors.lastname: Buono
authors.affiliation: b Neonatal Intensive Care Unit , Cardarelli Hospital , Campobasso , Italy , and.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Santillo
authors.affiliation: a Department of Obstetrics and Gynaecology , Policlinico A. Gemelli, Catholic University of Sacred Heart , Rome , Italy .
authors.forename: Angelo
authors.initials: A
authors.lastname: Licameli
authors.affiliation: c Division of Perinatal Medicine , Policlinico Abano Terme , Abano Terme , Italy.
authors.forename: Gianluca
authors.initials: G
authors.lastname: Straface
authors.affiliation: a Department of Obstetrics and Gynaecology , Policlinico A. Gemelli, Catholic University of Sacred Heart , Rome , Italy .
authors.forename: Giovanni
authors.initials: G
authors.lastname: Scambia
authors.affiliation: a Department of Obstetrics and Gynaecology , Policlinico A. Gemelli, Catholic University of Sacred Heart , Rome , Italy .
authors.forename: Marco
authors.initials: M
authors.lastname: De Santis
mesh_terms: D000293:Adolescent; D000328:Adult; D019072:Antibiotic Prophylaxis / Q000706:statistics & numerical data*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007558:Italy; D008403:Mass Screening / Q000706:statistics & numerical data*; D008875:Middle Aged; D011247:Pregnancy; D013290:Streptococcal Infections / Q000175:diagnosis* / Q000517:prevention & control; D013292:Streptococcus agalactiae / Q000302:isolation & purification*; D055815:Young Adult
keywords: Early-onset disease; GBS; Streptococcus agalactiae; intrapartum care