Group B Streptococcal sepsis: An old or ongoing threat?

Background: Group B Streptococcus (GBS) is a major cause of severe infections in newborns. Early-onset disease (EOD) occurs within the first week of life, and it is usually vertically transmitted. In late-onset disease (LOD), pathogens may also come from nosocomial sources. We report 3 cases of GBS infection in very low birth weight infants hospitalized by a neonatal intensive care unit (NICU) in Italy. Methods: The cluster was identified thanks to an active surveillance program; an epidemiologic investigation took place. Pulsed-field gel electrophoresis (PFGE) was used to assess the clonal relatedness of strains. An audit to stress the adherence to isolation precautions and hand hygiene was organized. Results: During a 16-day period, 2 preterm newborns developed GBS LOD; an earlier case of GBS EOD occurred in a baby hospitalized by the same ward. The 3 GBS strains had the same antibiotic susceptibility pattern. The PFGE profiles of the 2 cases of LOD are indistinguishable from each other and closely related with the case of EOD. Strict infection control measures were adopted. Conclusion: The implementation of additional infection control measures was able to stop the diffusion of infection; however, clusters like this should remind us the ongoing threat of GBS for the small NICU patients.