title: Early-onset neonatal sepsis and the implementation of group B streptococcus prophylaxis in a Brazilian maternity hospital: a descriptive study.
abstract: OBJECTIVE
  To describe early-onset neonatal sepsis (EOS) epidemiology in a public maternity hospital in Brasilia, Brazil.
  
  
  METHODS
  We defined EOS as a positive blood culture result obtained from infants aged ≤72 hours of life plus treatment with antibiotic therapy for ≥5 days. Incidence was calculated based on the number of cases and total live births (LB). This is a descriptive study comparing the period of 2012-2013 with the period of 2014-September 2015, before and after implementation of antibiotic prophylaxis during labor for group B streptococcus (GBS) prevention, respectively.
  
  
  RESULTS
  Overall, 36 infants developed EOS among 21,219 LB (1.7 cases per 1000 LB) and 16 died (case fatality rate of 44%). From 2014, 305 vaginal-rectal swabs were collected from high-risk women and 74 (24%) turned out positive for GBS. After implementation of GBS prevention guidelines, no new cases of GBS were detected, and the EOS incidence was reduced from 1.9 (95% CI 1.3-2.8) to 1.3 (95% CI 0.7-2.3) cases per 1000 LB from 2012-2013 to 2014-September 2015 (p=0.32).
  
  
  CONCLUSIONS
  Although the reduction of EOS incidence was not significant, GBS colonization among pregnant women was high, no cases of neonatal GBS have occurred after implementation of prevention guidelines.
authors.affiliation: Secretaria de Estado de Saúde do Distrito Federal, Hospital Materno Infantil de Brasília, Brasília, DF, Brazil; Universidade de Brasília, Núcleo de Medicina Tropical, Brasília, DF, Brazil. Electronic address: felipetmf@gmail.com.
authors.forename: Felipe Teixeira de Mello
authors.initials: FT
authors.lastname: Freitas
authors.affiliation: Universidade de Brasília, Núcleo de Medicina Tropical, Brasília, DF, Brazil.
authors.forename: Gustavo Adolfo Sierra
authors.initials: GA
authors.lastname: Romero
mesh_terms: D019072:Antibiotic Prophylaxis / Q000379:methods*; D001938:Brazil / Q000453:epidemiology; D004926:Escherichia coli / Q000187:drug effects / Q000302:isolation & purification; D004927:Escherichia coli Infections / Q000453:epidemiology / Q000517:prevention & control; D005260:Female; D006771:Hospitals, Maternity; D006801:Humans; D015994:Incidence; D008297:Male; D000071074:Neonatal Sepsis / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology* / Q000382:microbiology; D015203:Reproducibility of Results; D012307:Risk Factors; D013290:Streptococcal Infections / Q000453:epidemiology* / Q000517:prevention & control*; D013291:Streptococcus / Q000187:drug effects* / Q000302:isolation & purification; D016896:Treatment Outcome; D014626:Vaginal Smears
keywords: Brazil; Escherichia coli infection; Group B streptococcal disease; Neonatal sepsis