Neonatal Sepsis of Vertical Transmision. An epidemiological study from the “Grupo de Hospitales Castrillo”

• Published in: Early human development 2009, Vol.85 (10), p.S100-S100
• Main Authors: Lopez Sastre, Jose, Fernandez Colomer, Belen, Coto Cotallo, Gil D, Members of “Grupo de Hospitales Castrillo”
• Format: Article
• Language: English
• Subjects: Advanced Basic Science; Neonatal and Perinatal Medicine
• ISSN: 0378-3782; 1872-6232
• DOI: 10.1016/j.earlhumdev.2009.08.049

Introduction: Neonatal sepsis of vertical transmission occurs as a result of colonization of the fetus before or during labor by microorganisms from the maternal genital tract. Group B streptococcal (GBS) infection is the most frequent cause of vertical sepsis and a leading cause of neonatal mortality. In Spain, national guidelines for the prevention of perinatal GBS infection were issued in 1998. Objective: To assess the epidemiology of neonatal vertical sepsis in our country (Spain). Patients and methods: From 1996 the neonatal services of 34 acute-care teaching hospitals in Spain (“Grupo de Hospitales Castrillo”) carries out a prospective surveillance of the epidemiology of vertical neonatal sepsis. Results: In the study period (1996-2008) a total of 1,109.669 live birth were analyzed. The incidence of vertical confirmed sepsis declined by 55%, from 2.4/1000 live birth in 1996 to 1.08/10000 in 2008 (p < 0.001), without significant variation in vertical clinical sepsis (3.5/1000 and 2.5/1000 live birth respectively). The incidence of both confirmed sepsis and clinical sepsis was significantly higher in the group of VLBW neonates than in those weighing > 500 . The incidence of GBS vertical sepsis declined significantly by 73.6%, from 1.25/1000 live birth in 1996 to 0.33/1000 IN 2008 (p < 0.001). There were fluctuations in the incidence of E. coli infection and no significant variations of other gram negative bacteria. The mortality rate of proven sepsis ranged between 8-11% in the study period and was significantly higher in the VLBW cohort. The global mortality per 1000 live birth decreased from 0.33 to 0.18 per 1000 live birth. Conclusions: There was a substantial decline in the incidence of vertical confirmed sepsis with significant reduction in the incidence of GBS sepsis in the study period, as consequence of the impact of antimicrobial intrapartum prophylaxis. Fluctuations in the incidence of E. coli infection suggest the need for continuing epidemiological surveillance.