SPECIAL ARTICLE   

Gazzetta Medica Italiana - Archivio per le Scienze Mediche 2021 January-February;180(1-2):54-8

DOI: 10.23736/S0393-3660.19.04138-X

Copyright © 2019 EDIZIONI MINERVA MEDICA

language: Italian

Intrapartum prevention of early onset group B streptococcal infection

Francesca BARBIERI ✉, Annunziata MASTROGIACOMO, Luigi COBELLIS

Unit of Obstetrics and Gynecology, Sant’Anna e San Sebastiano Hospital, Caserta, Italy

The connatal infection by beta-hemolytic Streptococcus group B currently (GBS) occurs in Italy with an incidence of 0.5-1 per 1000 live births but still represents a dramatic event for possible neonatal complications such as meningitis, pneumonia, generalized sepsis, perinatal death . The bacterium is in fact the most implicated pathogen in severe cases of neonatal sepsis. Those born from preterm parts, of low birth weight or born from dystocia/instrumental birth or other obstetric complications such as fever in labor or prolonged premature rupture of the membranes are particularly at risk. The infection has a bimodal distribution with an early onset disease and a late onset disease. The correct management of asymptomatic pregnant patients requires the identification of asymptomatic carriers by carrying out a vaginal swab and a rectal swab at the term, however within five weeks from the expected date of delivery. In case of GBS colonization, adequate antibiotic treatment must be carried out in labor and at least 4 hours before birth (Intrapartum Antibiotic Prophylaxis) to prevent the possibility of vertical ascending infection between mother and newborn. Additional clinical and anamnestic criteria are specified to choose whether or not to carry out an intrapartum antibiotic prophylaxis.

KEY WORDS: Streptoccocus agalactiae; Infections; Vertical infectious disease transmission; Antibiotic prophylaxis