title: Group B streptococcus infections in neonates admitted to a German NICU: Emphasis on screening and adherence to pre-analytical recommendations.
abstract: Infections by group B streptococci (GBS), e.g. Streptococcus agalactiae, presenting as early-onset disease (EOD) or late-onset disease (LOD), are leading causes of severe infections in newborn and premature patients. Although screening and intra partum antibiotic prophylaxis are frequently performed, vertically transmitted GBS remain a challenge for pediatrics.
  
  
  
  In order to prevent or reduce potential life-threatening events, this study retrospectively investigated epidemiological, microbiological and clinical aspects of infants admitted to the Division of Neonatology at the Department of Pediatrics at the University Hospital Frankfurt, Germany (UHF).
  
  
  
  Between January 2010 and January 2016, perinatal GBS screening status, clinical presentation of EOD or LOD and therapeutic management of neonates admitted to UHF were retrospective analysed. Infants tested positive for GBS within their first three months of life were included; patient data were obtained from the chart report. Severity of neonatal disease was analysed by using the NEOMOD and CRIB score.
  
  
  
  108 GBS infected infants born to 105 mothers were observed. N=101 of them (93.5%) presented with EOD, whereof n=9 (10%) primarily presented with pneumonia or pneumothorax. In 82 (78%) mothers of infected infants GBS status was unknown prior to hospitalization of the neonate. 3/108 (2.8%) infants died from GBS septicemia.
  
  
  
  Avoidance of GBS transmission sub partu is the key issue in preventing neonatal GBS infection and should be the focus of preventive strategies. Our results highlight the impact of perinatal screening.
authors.affiliation: Institute for Medical Microbiology and Infection Control, University Hospital Frankfurt, Germany.
authors.forename: Claudia
authors.initials: C
authors.lastname: Reinheimer
authors.affiliation: Institute for Medical Microbiology and Infection Control, University Hospital Frankfurt, Germany.
authors.forename: Volkhard A J
authors.initials: VA
authors.lastname: Kempf
authors.affiliation: Department of Pediatrics, Division of Neonatology, University Hospital Frankfurt, Germany.
authors.forename: Boris E
authors.initials: BE
authors.lastname: Wittekindt
authors.affiliation: Department of Pediatrics, Division of Neonatology, University Hospital Frankfurt, Germany.
authors.forename: Antje
authors.initials: A
authors.lastname: Allendorf
authors.affiliation: Institute for Medical Microbiology and Infection Control, University Hospital Frankfurt, Germany.
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Wichelhaus
authors.affiliation: Institute for Medical Microbiology and Infection Control, University Hospital Frankfurt, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Hogardt
authors.affiliation: Department of Pediatrics, Division of Neonatology, University Hospital Frankfurt, Germany.
authors.forename: Rolf L
authors.initials: RL
authors.lastname: Schlößer
authors.affiliation: Department of Pediatrics, Division of Neonatology, University Hospital Frankfurt, Germany. Electronic address: doris.fischer@kgu.de.
authors.forename: Doris
authors.initials: D
authors.lastname: Fischer
mesh_terms: D000328:Adult; D005260:Female; D005858:Germany; D019983:Guideline Adherence; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical; D007363:Intensive Care Units, Neonatal / Q000592:standards*; D008297:Male; D009035:Mothers; D017410:Practice Guidelines as Topic; D013290:Streptococcal Infections / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy / Q000635:transmission
keywords: Early onset disease; Group B streptococcus; Intrapartum antibiotic prophylaxis; Late onset disease; Neonatology; Screening adherence