Group B streptococcal early-onset neonatal sepsis in the area of Barcelona (2004-2010). Analysis of missed opportunities for prevention
Por:
Gimenez, M, Sanfeliu, I, Sierra, M, Dopico, E, Juncosa, T, Andreu, A, Lite, J, Guardia, C, Sanchez, F, Bosch, J
Publicada:
1 ago 2015
Resumen:
Objectives: To study the evolution of the incidence of early-onset neonatal sepsis (EOS) by Streptococcus agalactiae in the area of Barcelona and to analyze failure of compliance with the prevention protocol.
Methods: A retrospective review was carried out on EOS cases in 8 Health-Care Centers in the Barcelona area between 2004 and 2010.
Results: Forty-nine newborns from 48 mothers were diagnosed with EOS. The incidence was 0.29% living newborns (0.18-0.47%.), with no significant differences in the fluctuations along the 7 years. The mortality rate was 8.16%. In 68.5% cases the maternal colonization studies were negative, and in 21% these studies were not performed. No risk factors were detected in 58.3% of pregnant women, and 22.9% of births were premature. In 58% of cases intra-partum antibiotic prophylaxis was not administered because it was not indicated, and in 42% due to failure to follow the protocol (3 strains were resistant to erythromycin). Resistance to clindamycin was 33.3%. The Streptococcus agalactiae serotypes more frequently isolated were in, v, and ia.
Conclusions: No significant changes were detected in the incidence of Streptococcus agalactiae EOS in the 7 years of the study. The increased sensitivity of screening methods with the use of molecular techniques, the performance of susceptibility testing of strains isolated from pregnant women, and the improvement of communication between Health-Care Centers, can contribute to a better implementation of the protocol, as well as to reduce the incidence of EOS.(C) 2014 Elsevier Espana, S.L.U. and Sociedad Espanola de Enfermedades Infecciosas y Microbiologia Clinica. All rights reserved.
Filiaciones:
Gimenez, M:
Hosp Univ Germans Trias Pujol, Serv Microbiol, Barcelona, Spain
Sanfeliu, I:
Corp Sanitaria Parc Tauli, Serv Microbiol, Barcelona, Spain
Sierra, M:
Hosp Barcelona, Serv Microbiol, Barcelona, Spain
Dopico, E:
Hosp Llobregat, Lab Clin Hosp, Barcelona, Spain
Juncosa, T:
Hosp Univ St Joan Deu, Esplugues Llobregat, Serv Microbiol, Barcelona, Spain
Andreu, A:
Hosp Valle De Hebron, Serv Microbiol, Barcelona, Spain
Lite, J:
Hosp Univ Mritua Terrassa, Lab Mirobiol, Barcelona, Spain
Guardia, C:
Inst Catala Salut, Lab Barcelones Nord Valles Oriental, Barcelona, Spain
Sanchez, F:
Hosp Santa Creu & Sant Pau, Serv Microbiol, Barcelona, Spain
Bosch, J:
Hosp Clin Barcelona, Serv Microbiol, Barcelona, Spain
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