Comparison of epidemiology of early-onset neonatal infection before and after implementation of universal prenatal gbs screening

Aim of the study: To describe epidemiology of early - onset neonatal infection (EOI) in a tertiary level hospital in Kaunas, Lithuania. Objectives: To estimate and compare the frequency of EOI suspicion in 2012 and 2014; to estimate and compare incidence of microbiologically confirmed and unconfirmed sepsis in 2012 and 2014; to estimate risk factors for EOI and compare the frequency between newborns with diagnosed infection; to compare EOI agents between the years when there were different methods of prevention. Methods: This is a descriptive study comparing the period of 2012 (when there was risk factors based prevention) with the period of 2014 (universal prenatal GBS screening), respectively. We analyzed all cases, when blood cultures were taken because of suspected EOI. Standard data collection form was used to collect all demographic data, clinical characteristics of neonates, maternal risk factors for GBS transmission, history of maternal GBS screening and GBS status, use of maternal antibiotic prophylaxis and neonatal outcome. Incidence was calculated based on the number of cases and total live births. Statistical analysis was done using „SPSS 17.0 for Windows“. Ethics approval was obtained from the Bioethic centre of Lithuanian University of Health Sciences Results: 100 (6,21%) blood cultures were taken because of suspected EOI in 2012 and 154 (9,37%) – in 2014. In 2012 40 cases of EOI have been diagnosed: overall incidence of sepsis (4,97/1000 live births), microbiologically confirmed sepsis 4 (2,5/1000 live births), microbiologically unconfirmed sepsis 4 (2,5/1000 live births). Sixty cases of EOI have been diagnosed in 2014: overall incidence of sepsis (1,8/1000 live births), microbiologically confirmed sepsis 2 (1,2/1000 live births), microbiologically unconfirmed sepsis 1 (0,6/1000 live births). There was no significant difference of frequency of risk factors. 2012 EOI agents: L. monocytogenes 0.62/1000 live births, K. pneumoniae 0.62/ 1000 live births, S. aureus 0.62/1000 live births, S. saprofiticus 0.62/1000 live births. 2014: L. monocytogenes 0.61/1000 live births, E. coli 0.61/1000 live births. Conclusions: There were no significant differences of frequency of EOI, risk factors and causative agents in 2012 and 2014, regardless of the method of prevention (risk factors based prevention and universal prenatal screening)