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4 results on '"Pagano, Rossella"'

1. Understanding Factors in Group B Streptococcus Late-Onset Disease

Author

Berardi,Alberto, Trevisani,Viola, Di Caprio,Antonella, Bua,Jenny, China,Mariachiara, Perrone,Barbara, Pagano,Rossella, Lucaccioni,Laura, Fanaro,Silvia, Iughetti,Lorenzo, Lugli,Licia, and Creti,Roberta

Subjects
Infection and Drug Resistance
Abstract

Alberto Berardi,1 Viola Trevisani,2 Antonella Di Caprio,2 Jenny Bua,3 Mariachiara China,4 Barbara Perrone,5 Rossella Pagano,6 Laura Lucaccioni,7 Silvia Fanaro,8 Lorenzo Iughetti,2,7 Licia Lugli,1 Roberta Creti9 1Terapia Intensiva Neonatale, Azienda Ospedaliero-Universitaria Policlinico, Modena, Italy; 2Scuola di Specializzazione in Pediatria, Università di Modena & Reggio Emilia, Modena, Italy; 3Terapia Intensiva Neonatale, IRCCS Azienda Ospedaliero Universitaria “Burlo Garofalo”, Trieste, Italy; 4Terapia Intensiva Neonatale, Ospedale Infermi, Rimini, Italy; 5Terapia Intensiva Neonatale, Azienda Ospedaliero Universitaria Ospedali Riuniti, Ancona, Italy; 6Unità Operativa di Pediatria, Civile Sassuolo, Sassuolo, Italy; 7Unità Operativa di Pediatria, Azienda Ospedaliero-Universitaria Policlinico, Modena, Italy; 8Terapia Intensiva Neonatale, Azienda Ospedaliero-Universitaria S. Anna, Ferrara, Italy; 9Reparto di Antibiotico Resistenza e Patogeni Speciali (AR-PS), Dipartimento di Malattie Infettive, Istituto Superiore di Sanità, Rome, ItalyCorrespondence: Alberto Berardi Tel +39 059 4222522Fax +39 059 42223770Email alberto.berardi@unimore.itAbstract: Group B streptococcus (GBS) infection remains a leading cause of sepsis, pneumonia, and meningitis in infants. Rates of GBS early onset disease have declined following the widcespread use of intrapartum antibiotic prophylaxis; hence, late-onset infections (LOGBS) are currently a common presentation of neonatal GBS dicsease. The pathogenesis, mode of transmission, and risk factors associated with LOGBS are unclear, which interfere with effective prevention efforts. GBS may be transmitted from the mother to the infant at the time of delivery or during the postpartum period via contaminated breast milk, or as nosocomial or community-acquired infection. Maternal GBS colonization, prematurity, young maternal age, HIV exposure, and ethnicity (Black) are identified as risk factors for LOGBS disease; however, further studies are necessary to confirm additional risk factors, if any, for the implementation of effective prevention strategies. This narrative review discusses current and previous studies that have reported LOGBS. Few well-designed studies have described this condition; therefore, reliable assessment of maternal GBS colonization, breastfeeding, and twin delivery as risk factors for LOGBS remains limited.Keywords: neonatal sepsis, prevention, infant, meningitis, CC17

Published
2021

2. Escherichia coli Is Overtaking Group B Streptococcus in Early-Onset Neonatal Sepsis.

Author

Miselli, Francesca, Cuoghi Costantini, Riccardo, Creti, Roberta, Sforza, Francesca, Fanaro, Silvia, Ciccia, Matilde, Piccinini, Giancarlo, Rizzo, Vittoria, Pasini, Lorena, Biasucci, Giacomo, Pagano, Rossella, Capretti, Mariagrazia, China, Mariachiara, Gambini, Lucia, Pulvirenti, Rita Maria, Dondi, Arianna, Lanari, Marcello, Pedna, MariaFederica, Ambretti, Simone, and Lugli, Licia

Subjects
STREPTOCOCCUS agalactiae, NEONATAL sepsis, ESCHERICHIA coli, LOGISTIC regression analysis, ANTIBIOTIC prophylaxis
Abstract

The widespread use of intrapartum antibiotic prophylaxis (IAP) to prevent group B streptococcus (GBS) early-onset sepsis (EOS) is changing the epidemiology of EOS. Italian prospective area-based surveillance data (from 1 January 2016 to 31 December 2020) were used, from which we identified 64 cases of culture-proven EOS (E. coli, n = 39; GBS, n = 25) among 159,898 live births (annual incidence rates of 0.24 and 0.16 per 1000, respectively). Approximately 10% of E. coli isolates were resistant to both gentamicin and ampicillin. Five neonates died; among them, four were born very pre-term (E. coli, n = 3; GBS, n = 1) and one was born full-term (E. coli, n = 1). After adjustment for gestational age, IAP-exposed neonates had ≥95% lower risk of death, as compared to IAP-unexposed neonates, both in the whole cohort (OR 0.04, 95% CI 0.00–0.70; p = 0.03) and in the E. coli EOS cohort (OR 0.05, 95% CI 0.00–0.88; p = 0.04). In multi-variable logistic regression analysis, IAP was inversely associated with severe disease (OR = 0.12, 95% CI 0.02–0.76; p = 0.03). E. coli is now the leading pathogen in neonatal EOS, and its incidence is close to that of GBS in full-term neonates. IAP reduces the risk of severe disease and death. Importantly, approximately 10% of E. coli isolates causing EOS were found to be resistant to typical first-line antibiotics. [ABSTRACT FROM AUTHOR]

Published
2022
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4. Risk factors for group B streptococcus early-onset disease: an Italian, area-based, case-control study.

Author

Berardi, Alberto, Spada, Caterina, Creti, Roberta, Ambretti, Simone, Chiarabini, Rossana, Barozzi, Agostino, Pagano, Rossella, Sarti, Mario, Pedna, Maria Federica, Fornaciari, Sara, Azzalli, Milena, Dodi, Icilio, Bacchi Reggiani, Maria Letizia, Lanzoni, Angela, Vaccina, Eleonora, Iughetti, Lorenzo, and Lucaccioni, Laura

Subjects
STREPTOCOCCAL disease prevention, COMMUNICABLE disease diagnosis, BETA lactam antibiotics, PRENATAL diagnosis, DISEASE incidence, STREPTOCOCCAL diseases, CASE-control method, ANTIBIOTIC prophylaxis, STREPTOCOCCUS, PREGNANCY complications, IMPACT of Event Scale, QUESTIONNAIRES, VERTICAL transmission (Communicable diseases)
Abstract

Purpose: Intrapartum antibiotic prophylaxis (IAP) prevents group B streptococcus (GBS) early-onset disease (EOD). No European study evaluates the relative impact of risk factors (RFs) for EOD after a screening-based strategy and widespread IAP use We aimed to evaluate the risks of EOD in an Italian region where a screening-based strategy for preventing EOD was implemented.Materials and methods: Cases of EOD born at or above 35 weeks' gestation were reviewed and matched with controls.Results: There were 109 cases of EOD among 532,154 live births. Most cases had negative GBS prenatal screening (56/91, 61.5%) and were unexposed to IAP (86/109, 78.9%). At multivariate analysis, GBS bacteriuria (OR = 6.99), positive prenatal screening (OR = 13.7) and maternal intrapartum fever (OR = 188.3) were associated with an increased risk of EOD, whereas intrapartum beta-lactam antibiotics were associated with a decreased risk of EOD (≥4 h: OR = 0.008; <4 h: OR = 0.04). Neonates born to nonfebrile, GBS positive pregnant women, receiving beta-lactam antibiotics had very low probability of EOD, particularly if IAP was adequate.Conclusions: GBS positive prenatal screening, GBS bacteriuria and intrapartum fever are associated with EOD. Intrapartum beta-lactam antibiotics reduce the probability of EOD in neonates born to nonfebrile mothers. [ABSTRACT FROM AUTHOR]

Published
2020
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