The bacterium group B Streptococcus (GBS) is the leading cause of neonatal bacterial infection in developed countries. GBS is a Gram positive bacterium located primarly in the gastrointestinal tract and genitourinary system. The presentation of GBS neonatal disease includes pneumonia, respiratory distress and meningitis. The newborn is colonized during passage through the birth canal. The mother, when colonized, is usually asymptomatic. GBS is present in the vagina of about 10-15% of women towards the end of pregnancy. During the first 7 days of life (early onset infection) about 3% of the colonized children develop the infection, especially meningitis, that may be fatal or leave sequelae; this infection predominantly results from vertical transmission of GBS from colonized mothers during the intrapartum period. Infection of GBS from one week to 90 days of age (late onset infection) results from transmission after birth. In Italy, according to national guidelines of pregnancy 2011, a culture-based screening approach is performed: all patients are screened for vaginal and rectal GBS between 36 and 37 weeks of gestation and if found positive are then treated with prophylactic antibiotics during labor. Intravenous intrapartum antibiotic prophylaxis (IAP) in women who carry GBS, from the onset of labour until delivery (given ≥ 4 hours before delivery), reduces the risk of early onset neonatal GBS infection from 4.7% to 0.4%. Penicillin G is the antibiotic of choice. In case of penicillin allergy, erythromicin or clindamycin are generally active against GBS and carry no particular risks for the infant.
Articoli Selezionati del “3° Convegno Pediatrico del Medio Campidano” · Guspini · 25 Maggio 2013
Guest Editor: Roberto Antonucci