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Open Access 01-12-2018 | Commentary

Secondary prevention of early-onset sepsis: a less invasive Italian approach for managing neonates at risk

Authors: Alberto Berardi, Chryssoula Tzialla, Laura Travan, Jenny Bua, Daniele Santori, Milena Azzalli, Caterina Spada, Laura Lucaccioni, on behalf of the GBS Prevention Working Group of Emilia-Romagna

Published in: Italian Journal of Pediatrics | Issue 1/2018

Abstract

Strategies to prevent early-onset sepsis (EOS) have led to a substantial decline in many countries. However, one of the most controversial topics in neonatology is the management of asymptomatic full-term and late preterm neonates at risk for EOS, and guidelines lack substantial consensus regarding this issue. A strategy for managing neonates, entirely based on serial physical examinations, has been developed in two Italian regions. This strategy seems safe, while reducing laboratory tests and unnecessary antibiotics. In the current commentary we provide area-based data concerning the prevention of EOS in 2 northern Italian regions, and we detail the results of their strategy for managing healthy-appearing newborns at risk for EOS.

Verani JR, McGee L, Schrag SJ. Division of bacterial diseases, National Center for Immunization and Respiratory Diseases, Centres for disease control and prevention (CDC). Prevention of perinatal group B streptococcal disease — revised guidelines from CDC, 2010. MMWR Recomm Rep. 2010;59(RR-10):1–36.PubMed

Benitz WE, Wynn JL, Polin RA. Reappraisal of guidelines for management of neonates with suspected early-onset sepsis. J Pediatr. 2015;166:1070–4.CrossRefPubMedPubMedCentral

Hughes RG, Brocklehurst P, Steer PJ, Heath P. Stenson BM on behalf of the Royal College of Obstetricians and Gynaecologists. Prevention of early-onset neonatal group B streptococcal disease. Green-top guideline no. 36. BJOG. 2017;124:e280–305. Accessed at 2 Mar 2017CrossRef

Tzialla C, Berardi A, Farina C, Clerici P, Borghesi A, Viora E, et al. Task force for group B streptococcal infections for the Italian Society of Neonatology; Italian Society of Obstetricians and Gynecologists; Italian Association of Clinical Microbiologists. Strategies for preventing group B streptococcal infections in newborns: a nation-wide survey of Italian policies. Ital J Pediatr. 2017;43:98.CrossRefPubMedPubMedCentral

Cantoni L, Ronfani L, Da Riol R, Demarini S. Physical examination instead of laboratory tests for most infants born to mothers colonized with group B Streptococcus: support for the Centers for Disease Control and Prevention’s 2010 recommendations. J Pediatr. 2013;163:568–73.CrossRefPubMed

Berardi A, Lugli L, Rossi C, Guidotti I, Lanari M, Creti R, et al. Impact of perinatal practices for early-onset group B streptococcal disease prevention. Pediatr Infect Dis J. 2013;32:e265–71.CrossRefPubMed

Berardi A, Lugli L, Baronciani D, Creti R, Rossi K, Ciccia M, et al. GBS prevention working Group of Emilia-Romagna.. Group B streptococcal infections in a northern region of Italy. Pediatrics. 2007;120:e487–93.CrossRefPubMed

Berardi A, Di Fazzio G, Gavioli S, Grande E, Groppi A, Papa I, et al. Universal antenatal screening for group B streptococcus in Emilia-Romagna. J Med Screen. 2011;18:60–4.CrossRefPubMed

Berardi A, Baroni L, Bacchi Reggiani ML, Ambretti S, Biasucci G, Bolognesi S, et al. GBS prevention working group Emilia-Romagna.. The burden of early-onset sepsis in Emilia-Romagna (Italy): a 4-year, population-based study. J Matern Fetal Neonatal Med. 2016;29:3126–31.PubMed

10.

Berardi A, Rossi C, Bacchi Reggiani ML, Bastelli A, Capretti MG, Chiossi C, et al. An area-based study on intrapartum antibiotic prophylaxis for preventing group B streptococcus early-onset disease: advances and limitations. J Matern Fetal Neonatal Med. 2017;30:1739–44.CrossRefPubMed

11.

Berardi A, Fornaciari S, Rossi C, Patianna V, Bacchi Reggiani ML, Ferrari F, et al. Safety of physical examination alone for managing well-appearing neonates ≥ 35 weeks' gestation at risk for early-onset sepsis. J Matern Fetal Neonatal Med. 2015;28:1123–7.CrossRefPubMed

12.

Berardi A, Buffagni AM, Rossi C, Vaccina E, Cattelani C, Gambini L, Baccilieri F, et al. Serial physical examinations, a simple and reliable tool for managing neonates at risk for early-onset sepsis. World J Clin Pediatr. 2016;5:358–64.CrossRefPubMedPubMedCentral

13.

van Herk W, el Helou S, Janota J, Hagmann C, Klingenberg C, Staub E, et al. Variation in current Management of Term and Late-preterm Neonates at risk for early-onset Sepsis: an international survey and review of guidelines. Pediatr Infect Dis J. 2016;35:494–500.CrossRefPubMed

14.

Tzialla C, Borghesi A, Serra G, Stronati M, Corsello G. Antimicrobial therapy in neonatal intensive care unit. Ital J Pediatr. 2015;41:27.CrossRefPubMedPubMedCentral

15.

Hooven TA, Randis TM, Polin RA. What's the harm? Risks and benefits of evolving rule-out sepsis practices. J Perinatol. 2018;26 [Epub ahead of print]

Title: Secondary prevention of early-onset sepsis: a less invasive Italian approach for managing neonates at risk
Authors: Alberto Berardi
Chryssoula Tzialla
Laura Travan
Jenny Bua
Daniele Santori
Milena Azzalli
Caterina Spada
Laura Lucaccioni
on behalf of the GBS Prevention Working Group of Emilia-Romagna
Publication date: 01-12-2018
Publisher: BioMed Central
Published in: Italian Journal of Pediatrics / Issue 1/2018
Electronic ISSN: 1824-7288
DOI: https://doi.org/10.1186/s13052-018-0515-8

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Secondary prevention of early-onset sepsis: a less invasive Italian approach for managing neonates at risk

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