Review
Immunology
Konstantinos Karampatsas, Hannah Davies, Maren Mynarek, Nick Andrews, Paul T. Heath, Kirsty Le Doare
Summary: Prematurity/low birth weight and maternal colonization are major risk factors for late-onset Group B streptococcal infection. Future vaccine studies should identify the optimal time for vaccination during pregnancy to protect preterm infants.
CLINICAL INFECTIOUS DISEASES
(2022)
Article
Immunology
Mirjam Freudenhammer, Konstantinos Karampatsas, Kirsty Le Doare, Fabian Lander, Jakob Armann, Daniel Acero Moreno, Margaret Boyle, Horst Buxmann, Ruth Campbell, Victoria Chalker, Robert Cunney, Lorraine Doherty, Eleri Davies, Androulla Efstratiou, Roland Elling, Matthias Endmann, Jochen Essers, Roland Hentschel, Christine E. Jones, Steffen Kallsen, Georgia Kapatai, Marcus Kruger, Shamez Ladhani, Theresa Lamagni, Diane Lindsay, Mary Meehan, Catherine P. O'Sullivan, Darshana Patel, Arlene J. Reynolds, Claudia Roll, Sven Schulzke, Andrew Smith, Anja Stein, Axel von der Wense, Egbert Voss, Christian Wieg, Christoph Hartel, Paul T. Heath, Philipp Henneke
Summary: The risk of iGBS is higher among infants from multiple births if one infant has already developed GBS disease. In recurrent cases, the interval of onset of iGBS between siblings is longer. Disturbances of the individual microbiome are suggested to be associated with recurrent GBS infections.
FRONTIERS IN IMMUNOLOGY
(2021)
Article
Public, Environmental & Occupational Health
Ziyaad Dangor, Anna C. Seale, Vuyelwa Baba, Gaurav Kwatra
Summary: Invasive group B streptococcal (GBS) disease is a significant problem in newborns, especially in African countries where preventive strategies are limited. The high mortality and serious neurodevelopmental impairments caused by GBS emphasize the need for a maternal vaccine. Ongoing clinical trials are evaluating the safety and efficacy of hexavalent polysaccharide protein conjugate and Alpha family surface protein vaccines.
FRONTIERS IN PUBLIC HEALTH
(2023)
Review
Infectious Diseases
Alberto Berardi, Viola Trevisani, Antonella Di Caprio, Jenny Bua, Mariachiara China, Barbara Perrone, Rossella Pagano, Laura Lucaccioni, Silvia Fanaro, Lorenzo Lughetti, Licia Lugli, Roberta Creti
Summary: Group B streptococcus (GBS) infection remains a leading cause of sepsis, pneumonia, and meningitis in infants, with early onset cases decreasing due to widespread use of intrapartum antibiotics, leading to late-onset infections as common presentation. The pathogenesis, mode of transmission, and risk factors for LOGBS are unclear, hindering effective prevention efforts.
INFECTION AND DRUG RESISTANCE
(2021)
Article
Pediatrics
Natasha S. Ching, Jim P. Buttery, Emily Lai, Andrew C. Steer, Jane Standish, Joel Ziffer, Andrew J. Daley, Richard Doherty
Summary: The study found no association between breastfeeding and the increased risk of LOGBS. Breast milk should not be tested for GBS during the initial episode of LOGBS.
Article
Medicine, General & Internal
Jubara Alallah, Khaild Ridnah, Bakur A. Turkstani, Saeed N. Albukhari
Summary: Group B streptococcal (GBS) infection is a leading cause of neonatal sepsis, with early-onset infections declining but late-onset infections remaining unchanged. Twins with late-onset GBS sepsis are rare.
CUREUS JOURNAL OF MEDICAL SCIENCE
(2023)
Article
Obstetrics & Gynecology
Ying Tze Viola Chan, Steven Yuk Fai Lau, Shuk Yi Annie Hui, Teresa Ma, Choi Wah Kong, Lee Ting Kwong, Diana Chan, Diana Lee, Sau Lan Mok, Vinci Ma, Yim Chong Lo, Kwok Yin Leung, Wing Cheong Leung
Summary: This retrospective cohort study aimed to compare the incidences of early and late-onset neonatal sepsis, including group B streptococcus (GBS) and Escherichia coli (E. coli), before and after the implementation of universal screening and intrapartum antibiotics prophylaxis (IAP). The study found that the implementation of GBS screening and IAP was associated with a reduction in early-onset neonatal sepsis, including GBS disease. There was no significant evidence of an increase in the incidence of late-onset neonatal sepsis, including those caused by GBS.
BJOG-AN INTERNATIONAL JOURNAL OF OBSTETRICS AND GYNAECOLOGY
(2023)
Article
Pediatrics
Carlo Dani, Giulia Remaschi, Nicolo Monti, Simone Pratesi
Summary: This study explored the correlation between COHb levels and the risk for late-onset sepsis (LOS) in preterm infants. The results showed that higher COHb levels 2 days before the diagnosis of LOS increased the risk for LOS development. A COHb level of 1.55% was identified as the best predictive threshold for LOS.
EUROPEAN JOURNAL OF PEDIATRICS
(2023)
Article
Immunology
Lubna Hamdan, Simon Vandekar, Andrew J. Spieker, Herdi Rahman, Danielle Ndi, Emily S. Shekarabi, Jyotsna Thota, Danielle A. Rankin, Zaid Haddadin, Tiffanie Markus, David M. Aronoff, William Schaffner, Jennifer A. Gaddy, Natasha B. Halasa
Summary: The study found racial disparities in rates of early-onset and late-onset GBS disease among infants, with black infants showing significant decreasing temporal trends in both EOGBS and LOGBS over the past decade in Tennessee. In contrast, there were no changes noted among white infants. Additional studies are needed to further characterize these disparities and identify factors influencing them.
CLINICAL INFECTIOUS DISEASES
(2021)
Article
Microbiology
Alberto Berardi, Viola Trevisani, Antonella Di Caprio, Paola Caccamo, Giuseppe Latorre, Sabrina Loprieno, Alessandra Foglianese, Nicola Laforgia, Barbara Perrone, Giangiacomo Nicolini, Matilde Ciccia, Maria Grazia Capretti, Chiara Giugno, Vittoria Rizzo, Daniele Merazzi, Silvia Fanaro, Lucia Taurino, Rita Maria Pulvirenti, Silvia Orlandini, Cinzia Auriti, Cristina Haass, Laura Ligi, Giulia Vellani, Chryssoula Tzialla, Cristina Tuoni, Daniele Santori, Lorenza Baroni, Mariachiara China, Jenny Bua, Federica Visintini, Lidia Decembrino, Roberta Creti, Francesca Miselli, Luca Bedetti, Licia Lugli
Summary: The effectiveness of inadequate intrapartum antibiotic prophylaxis (IAP administered < 4 h prior to delivery) in preventing early-onset sepsis (EOS) is debated. Italian prospective surveillance cohort data (2003-2022) were used to study the type and duration of IAP according to the timing of symptoms onset of group B streptococcus (GBS) and E. coli culture-confirmed EOS cases. IAP-exposed neonates frequently develop symptoms of EOS after birth, up to 48 h of life and beyond.
Review
Microbiology
Mahin Delara, Nirma Khatri Vadlamudi, Manish Sadarangani
Summary: Group B Streptococcus is a bacterium that can cause infections in pregnant women and newborns, resulting in adverse outcomes. Current preventive measures include intrapartum antibiotic prophylaxis, but it is not effective for all cases. Probiotics and immunization in pregnancy show promising results in preventing Group B Streptococcus infections. Challenges in developing GBS vaccines include understanding the optimal timing of administration and potential serotype switching.
Article
Microbiology
Francesca Miselli, Riccardo Cuoghi Costantini, Roberta Creti, Francesca Sforza, Silvia Fanaro, Matilde Ciccia, Giancarlo Piccinini, Vittoria Rizzo, Lorena Pasini, Giacomo Biasucci, Rossella Pagano, Mariagrazia Capretti, Mariachiara China, Lucia Gambini, Rita Maria Pulvirenti, Arianna Dondi, Marcello Lanari, MariaFederica Pedna, Simone Ambretti, Licia Lugli, Luca Bedetti, Alberto Berardi
Summary: The widespread use of intrapartum antibiotic prophylaxis has changed the epidemiology of early-onset sepsis, with E. coli becoming the leading pathogen. Intrapartum antibiotic prophylaxis significantly reduces the risk of severe disease and death. However, it is important to note that approximately 10% of E. coli causing early-onset sepsis are resistant to first-line antibiotics.
Article
Immunology
Xuelian Wang, Peggy Hiu Ying Chan, Hoi Ying Sharon Lau, Kathleen Tsoi, Hugh Simon Lam
Summary: The pathogen profile of neonatal early-onset sepsis (EOS) has changed with the implementation of universal maternal group B Streptococcus (GBS) screening. Streptococcus bovis has emerged as a more common pathogen associated with the risk of meningitis. In infants born <34 weeks, intrapartum antibiotic prophylaxis (IAP) may not be as effective in reducing EOS rate compared to those born ≥34 weeks, suggesting the need for new strategies.
PEDIATRIC INFECTIOUS DISEASE JOURNAL
(2023)
Article
Immunology
Francesco Giuseppe Ecclesia, Jose Antonio Alonso Cadenas, Borja Gomez, Iker Gangoiti, Susanna Hernandez-Bou, Mercedes de la Torre Espi
Summary: Background: This study aimed to describe the infants presenting to pediatric emergency departments (PEDs) and diagnosed with group B Streptococcus (GBS) late-onset disease (LOD) bacteremia and identify risk factors for severe infection and pediatric intensive care unit (PICU) admission. The results showed that infants with GBS LOD frequently develop sepsis/septic shock and bacterial meningitis, associated with a higher morbidity and mortality rate. Clinical appearance was the only risk factor for severe infection, whereas leukopenia was related to PICU admission.
PEDIATRIC INFECTIOUS DISEASE JOURNAL
(2022)
Article
Infectious Diseases
Aiyun Li, Ming Fang, Dongjie Hao, Qiaoai Wu, Yaqi Qian, Hao Xu, Bo Zhu
Summary: Through whole-genome sequencing and phylogenetic analysis, this study confirmed that a premature infant's late-onset group B Streptococcus (LOGBS) sepsis originated from his mother's breast milk. This finding suggests that WGS diagnosis is an effective tool for infection tracing and provides direction for preventing late-onset GBS infection.
INFECTION AND DRUG RESISTANCE
(2022)
Article
Pediatrics
Enrico Apa, Maria Teresa Presutti, Cecilia Rossi, Maria Federica Roversi, Salvatore Neri, Giancarlo Gargano, Giovanni Bianchin, Valeria Polizzi, Valeria Caragli, Daniele Monzani, Alberto Berardi, Silvia Palma, Elisabetta Genovese
Summary: This study investigated the impact of maternal SARS-CoV-2 infection during pregnancy on newborn hearing function. The results showed that the infection does not lead to moderate or severe hearing loss in infants, but may be associated with middle ear disorders.
Article
Pediatrics
Luca Bedetti, Isotta Zinani, Licia Lugli, Lorenzo Iughetti, Fabio Facchinetti, Alberto Berardi
Article
Obstetrics & Gynecology
Anna L. L. Tramontano, Daniela Menichini, Sara Lazzarin, Alessandra Sponzilli, Isotta Zinani, Fabio Facchinetti, Alberto Berardi
Summary: This retrospective cohort study aimed to evaluate the effects of prolonged rupture of membranes (ROMs) on perinatal outcomes. The study found that neonates born after ROM = 24 hours were more likely to require mechanical ventilation and continuous positive airway pressure. Additionally, infants born to Group-B Streptococcus-negative women with ROM = 24 hours had a higher risk of neonatal respiratory distress. Further investigations are needed to understand the association.
AMERICAN JOURNAL OF PERINATOLOGY
(2023)
Article
Immunology
Sara De Biasi, Anita Neroni, Milena Nasi, Domenico Lo Tartaro, Rebecca Borella, Lara Gibellini, Laura Lucaccioni, Emma Bertucci, Licia Lugli, Francesca Miselli, Luca Bedetti, Isabella Neri, Fabrizio Ferrari, Fabio Facchinetti, Alberto Berardi, Andrea Cossarizza
Summary: Preterm newborns have altered innate immunity and impaired monocyte function, as well as a pro-inflammatory plasma profile. Our research found higher proportions of immature monocytes and CD56(+/-)CD16(+)NK cells, and lower proportions of classical monocytes in preterm infants compared to full-term infants. Gene expression analysis revealed lower inflammasome activation and higher concentrations of alarmin S100A8 in preterm infants' monocytes and plasma. These findings may explain the increased susceptibility of preterm infants to infections and have implications for developing new therapeutic strategies.
EUROPEAN JOURNAL OF IMMUNOLOGY
(2023)
Article
Multidisciplinary Sciences
Martin Stocker, Claus Klingenberg, Lars Naver, Viveka Nordberg, Alberto Berardi, Salhab el Helou, Gerhard Fusch, Joseph M. Bliss, Dirk Lehnick, Varvara Dimopoulou, Nicholas Guerina, Joanna Seliga-Siwecka, Pierre Maton, Donatienne Lagae, Judit Mari, Jan Janota, Philipp K. A. Agyeman, Riccardo Pfister, Giuseppe Latorre, Gianfranco Maffei, Nichola Laforgia, Eniko Mozes, Ketil Stordal, Tobias Strunk, Eric Giannoni
Summary: Fear of missing neonatal sepsis drives early antibiotic administration in infants, despite lacking culture-proven sepsis. This practice can contribute to antimicrobial resistance and disruption of the developing microbiome, increasing the risk of chronic diseases later in life. To address this, a factual approach is advocated to balance the burden of treatment and disease, ensuring proper antimicrobial stewardship and sepsis management.
NATURE COMMUNICATIONS
(2023)
Article
Microbiology
Luca Bedetti, Francesca Miselli, Chiara Minotti, Giuseppe Latorre, Sabrina Loprieno, Alessandra Foglianese, Nicola Laforgia, Barbara Perrone, Matilde Ciccia, Maria Grazia Capretti, Chiara Giugno, Vittoria Rizzo, Daniele Merazzi, Silvia Fanaro, Lucia Taurino, Rita Maria Pulvirenti, Silvia Orlandini, Cinzia Auriti, Cristina Haass, Laura Ligi, Giulia Vellani, Chryssoula Tzialla, Cristina Tuoni, Daniele Santori, Mariachiara China, Lorenza Baroni, Silvia Nider, Federica Visintini, Lidia Decembrino, Giangiacomo Nicolini, Roberta Creti, Elena Pellacani, Arianna Dondi, Marcello Lanari, Belinda Benenati, Giacomo Biasucci, Lucia Gambini, Licia Lugli, Alberto Berardi
Summary: This study evaluated the rates of lumbar puncture in infants with culture-proven sepsis. The results showed that lumbar puncture was infrequently performed after antibiotic initiation, leading to a reduced ability to identify the pathogen in cerebrospinal fluid culture. Polymerase chain reaction increased the probability of positive results compared to microbiological culture.
Article
Microbiology
Alberto Berardi, Viola Trevisani, Antonella Di Caprio, Paola Caccamo, Giuseppe Latorre, Sabrina Loprieno, Alessandra Foglianese, Nicola Laforgia, Barbara Perrone, Giangiacomo Nicolini, Matilde Ciccia, Maria Grazia Capretti, Chiara Giugno, Vittoria Rizzo, Daniele Merazzi, Silvia Fanaro, Lucia Taurino, Rita Maria Pulvirenti, Silvia Orlandini, Cinzia Auriti, Cristina Haass, Laura Ligi, Giulia Vellani, Chryssoula Tzialla, Cristina Tuoni, Daniele Santori, Lorenza Baroni, Mariachiara China, Jenny Bua, Federica Visintini, Lidia Decembrino, Roberta Creti, Francesca Miselli, Luca Bedetti, Licia Lugli
Summary: The effectiveness of inadequate intrapartum antibiotic prophylaxis (IAP administered < 4 h prior to delivery) in preventing early-onset sepsis (EOS) is debated. Italian prospective surveillance cohort data (2003-2022) were used to study the type and duration of IAP according to the timing of symptoms onset of group B streptococcus (GBS) and E. coli culture-confirmed EOS cases. IAP-exposed neonates frequently develop symptoms of EOS after birth, up to 48 h of life and beyond.
Review
Infectious Diseases
Giovanni Autore, Luca Bernardi, Filippo Ghidini, Claudio La Scola, Alberto Berardi, Giacomo Biasucci, Federico Marchetti, Andrea Pasini, Maria Elena Capra, Claudia Castellini, Vera Cioni, Sante Cantatore, Andrea Cella, Francesca Cusenza, Alessandro De Fanti, Elisa Della Casa Muttini, Margherita Di Costanzo, Alessandra Dozza, Claudia Gatti, Cristina Malaventura, Luca Pierantoni, Giovanni Parente, Gabriella Pelusi, Serafina Perrone, Laura Serra, Francesco Torcetta, Enrico Valletta, Gianluca Vergine, Francesco Antodaro, Andrea Bergomi, Jennifer Chiarlolanza, Laura Leoni, Franco Mazzini, Roberto Sacchetti, Agnese Suppiej, Lorenzo Iughetti, Andrea Pession, Mario Lima, Susanna Esposito
Summary: Low-dose continuous antibiotic prophylaxis (CAP) is commonly used to prevent urinary tract infections (UTIs) in children, but its efficacy is controversial. This systematic review found that CAP has a limited role in preventing UTI recurrences and complications in children, while also posing a risk of emerging antimicrobial resistances.
Article
Pediatrics
Luca Bedetti, Licia Lugli, Natascia Bertoncelli, Eugenio Spaggiari, Elisabetta Garetti, Laura Lucaccioni, Federica Cipolli, Alberto Berardi
Summary: Early skin-to-skin contact (SSC) is safe for preterm infants and can be performed in the first few weeks of life, which should reassure healthcare professionals and parents.
Article
Medicine, Research & Experimental
Iuri Corsini, Javier Rodriguez-Fanjul, Francesco Raimondi, Luca Boni, Alberto Berardi, Victoria Aldecoa-Bilbao, Almudena Alonso-Ojembarrena, Gina Ancora, Salvatore Aversa, Renzo Beghini, Nerea Bilbao Meseguer, Letizia Capasso, Francesca Chesi, Martina Ciarcia, Ana Concheiro, Luigi Corvaglia, Benjamim Ficial, Luca Filippi, Jesus Fuentes Carballal, Monica Fusco, Sara Gatto, Gemma Ginovart, Rebeca Gregorio-Hernandez, Gianluca Lista, Manuel Sanchez-Luna, Silvia Martini, Luca Massenzi, Francesca Miselli, Domenica Mercadante, Fabio Mosca, Marta Teresa Palacio, Alessandro Perri, Francesca Piano, Marcelino Pumarada Prieto, Lorena Rodeno Fernandez, Francesco Maria Risso, Marilena Savoia, Alex Staffler, Giovanni Vento, Carlo Dani
Summary: This study aims to determine whether the use of lung ultrasound score (LUS) as a decision tool for surfactant replacement therapy (SRT) in preterm infants with respiratory distress syndrome (RDS) can reduce the incidence of bronchopulmonary dysplasia (BPD) or death. A total of 668 spontaneously-breathing preterm infants, born at 25+0 to 29+6 weeks' gestation, will be randomized into a control group and a study group. The control group will receive SRT only when the fraction of inspired oxygen (FiO2) exceeds 0.3, while the study group will receive SRT if the LUS score is higher than 8 or the FiO2 requirements exceed 0.3. The primary outcome will be the difference in proportion of infants with BPD or death between the study and control groups.
Article
Infectious Diseases
Chiara Minotti, Antonella Di Caprio, Laura Facchini, Luca Bedetti, Francesca Miselli, Cecilia Rossi, Elisa Della Casa Muttini, Licia Lugli, Laura Luppi, Filippo Ferrari, Alberto Berardi
Summary: Neonatal sepsis is a significant cause of morbidity and mortality in neonatal intensive care units. This study aimed to evaluate the impact of an antimicrobial stewardship (AMS) program on the incidence and resistance profiles of neonatal sepsis. The results showed no significant differences in mortality and multidrug-resistant pathogens rates between the two study periods. The study highlights the importance of continuous optimization of infection prevention and control practices to limit antimicrobial resistance escalation.
Article
Biochemistry & Molecular Biology
Licia Lugli, Elisabetta Garetti, Bianca Maria Goffredo, Francesco Candia, Sara Crestani, Caterina Spada, Isotta Guidotti, Luca Bedetti, Francesca Miselli, Elisa Muttini Della Casa, Maria Federica Roversi, Raffaele Simeoli, Sara Cairoli, Daniele Merazzi, Paola Lago, Lorenzo Iughetti, Alberto Berardi
Summary: This study aims to evaluate the pharmacokinetic characteristics of fentanyl in full-term newborns with hypoxic-ischemic encephalopathy (HIE) who have undergone therapeutic hypothermia (TH). By measuring fentanyl plasma concentrations, the study aims to optimize the dosing regimen of fentanyl during TH.
Review
Pediatrics
Tommaso Zini, Francesca Miselli, Alberto Berardi
Summary: Definitions of bronchopulmonary dysplasia (BPD) or post-prematurity respiratory disease (PPRD) focus on categorizing mortality and morbidity risk, with an emphasis on long-term respiratory outcomes. Lack of a unified BPD classification and definitive treatment for extremely premature infants with BPD persists. However, stem cell-based postnatal therapies may offer hope for high-risk premature infants, while noninvasive tools like near-infrared spectroscopy (NIRS) can provide early, accurate, and reliable BPD assessment.