title: Neonatal Group B Streptococcus Infections: Prevention Strategies, Clinical and Microbiologic Characteristics in 7 Years of Surveillance.
abstract: The characteristics of group B streptococcus (GBS) neonatal disease in a period of 7 years are reported.
  
  
  
  The estimation of the neonatal GBS disease risk and prevention strategies adopted at delivery in absence of national guidelines was evaluated by the analysis of 3501 questionnaires. Notification of 194 neonatal GBS infections was recorded. In addition, 115 strains from neonatal early-onset disease (EOD) and late-onset disease, respectively, plus 320 strains from pregnant women were analyzed by molecular typing methods and for antibiotic resistance.
  
  
  
  Preterm deliveries, precipitous labor and GBS negatively screened mothers were the prominent causes for an inadequate or lack of intrapartum antibiotic prophylaxis and EOD occurrence. The superimposable serotype distribution of GBS strains from EOD and from antenatal screening confirmed the vertical transmission from mother to neonate as the cause of disease. On the contrary, late-onset disease was almost exclusively caused by the internationally diffused clonal complex 17. Erythromycin resistance was detected in 17% of strains. Resistance to clindamycin was 15.3 %.
  
  
  
  The administration of intrapartum antibiotic prophylaxis to negatively GBS screened women in presence of risk factors was a deviation from the recommendations issued by the Centers for Disease Control and Prevention, and it should deserve further consideration. Routine surveillance and molecular typing of circulating clones are essential for the effective management of the neonatal GBS disease.
authors.affiliation: From the *Dipartimento di Malattie Infettive, Parassitarie ed Immunomediate, Istituto Superiore di Sanità, Rome, Italy; and †Unità Operativa di Neonatologia, Dipartimento Materno-Infantile, Azienda Ospedaliero-Universitaria, Policlinico di Modena, Modena, Italy.
authors.forename: Roberta
authors.initials: R
authors.lastname: Creti
authors.forename: Monica
authors.initials: M
authors.lastname: Imperi
authors.forename: Alberto
authors.initials: A
authors.lastname: Berardi
authors.forename: Marco
authors.initials: M
authors.lastname: Pataracchia
authors.forename: Simona
authors.initials: S
authors.lastname: Recchia
authors.forename: Giovanna
authors.initials: G
authors.lastname: Alfarone
authors.forename: Lucilla
authors.initials: L
authors.lastname: Baldassarri
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology; D002981:Clindamycin / Q000494:pharmacology; D003430:Cross-Sectional Studies; D024881:Drug Resistance, Bacterial; D004917:Erythromycin / Q000494:pharmacology; D006801:Humans; D007231:Infant, Newborn; D017720:Molecular Epidemiology; D012307:Risk Factors; D065288:Serogroup; D013290:Streptococcal Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control*; D013292:Streptococcus agalactiae / Q000187:drug effects / Q000235:genetics*
chemical_list: D000900:Anti-Bacterial Agents; D002981:Clindamycin; D004917:Erythromycin