Management of Infants Born to Group B Streptococcus Positive Mothers.
Management of Infants Born to Group B Streptococcus Positive Mothers.
Intrapartum antibiotic prophylaxis has greatly decreased but not abolished early-onset
 neonatal sepsis caused by GBS. According to current recommendations, the evaluation of
 infants at risk for GBS sepsis should include a complete blood count (CBC), WBC differential,
 a blood culture (BC) and a period of observation. The usefulness of CBC and BC in the
 evaluation process is not firmly established.
After implementation of appropriate guidelines, early-onset GBS sepsis has become a low
 incidence disease (CDC). Recent rates are as low as 0.34 cases /1000 live births. According
 to CDC recommendations, the evaluation of infants at risk for GBS sepsis should include a
 complete blood count (CBC), WBC differential, a blood culture (BC) and a period of
 observation. The usefulness of CBC and BC in the evaluation process is not firmly
 established. There are several reviews on the predictive value of CBC and putative markers of
 early onset neonatal sepsis, but there seems to be no ideal laboratory test to assist the
 clinician in the diagnosis (Fowlie 1998, Malik 2003, Ottolini 2003). Given the continuing
 concerns about the reliability of laboratory tests, one may ask the question of whether
 physical examination might be at least as good as haematological indices. We are not aware of
 studies assessing the value of physical examination vs CBC, in the evaluation of asymptomatic
 at risk newborns.

 The aim of this study was to compare two approaches in the management of infants at risk for
 GBS sepsis: laboratory tests (CBC, differential and BC) with observation vs clinical
 observation alone.
Inclusion Criteria:

 -  All newborns born in Friuli Venezia Giulia Region (Italy)