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Incidence and serotype distribution of invasive group B streptococcal disease in young infants: a multi-country observational study.

Rivera L, Sáez-Llorens X, Feris-Iglesias J, Ip M, Saha S, Adrian PV, Madhi SA, Boudville IC, Cunnington MC, Casellas JM, Slobod KS - BMC Pediatr (2015)

Bottom Line: At 2.35 (95% CI: 1.74-3.18) cases per 1000 live births, the incidence of early onset GBS disease (EOD) was highest in the Dominican Republic, compared with 0.76 (95% CI: 0.41-1.39) in Hong Kong and 0.77 (95% CI: 0.44-1.35) in Panama, while no cases were identified in Bangladesh.The failure to identify GBS cases in Bangladesh highlights a need to better understand the contribution of population, healthcare and surveillance practice to variation in reported incidence.Overall, the identified disease burden and serotype distribution support the need for effective prevention methods in these populations, and the need for community based surveillance studies in rural areas where access to healthcare may be challenging.

View Article: PubMed Central - PubMed

Affiliation: Hospital Maternidad Nuestra Señora de la Altagracia, Santo Domingo, Dominican Republic. lrp@claro.net.do.

ABSTRACT

Background: Group B Streptococcus (GBS) is a leading cause of serious infection in very young infants. Robust incidence data from many geographic regions, including Latin America and Asia, are however lacking.

Methods: A multicenter, hospital-based observational study was performed in Panama, Dominican Republic, Hong Kong and Bangladesh. All represented urban, tertiary referral hospitals, except Bangladesh. GBS cases (microbiological isolation from normally sterile sites in infants aged 0-89 days) were collected over 12 months.

Results: At 2.35 (95% CI: 1.74-3.18) cases per 1000 live births, the incidence of early onset GBS disease (EOD) was highest in the Dominican Republic, compared with 0.76 (95% CI: 0.41-1.39) in Hong Kong and 0.77 (95% CI: 0.44-1.35) in Panama, while no cases were identified in Bangladesh. Over 90% of EOD cases occurred on the first day of life, with case fatality ratios ranging from 6.7% to 40%, varying by center, age of onset and clinical presentation. Overall, 90% of GBS (EOD and late onset disease) was due to serotypes Ia, Ib and III.

Conclusions: The incidence rate of early onset GBS infection reported in Dominican Republic was not dissimilar from that described in the United States prior to screening and intrapartum antibiotic prophylaxis, while the incidence in Hong Kong was higher than previously reported in the Asian region. The failure to identify GBS cases in Bangladesh highlights a need to better understand the contribution of population, healthcare and surveillance practice to variation in reported incidence. Overall, the identified disease burden and serotype distribution support the need for effective prevention methods in these populations, and the need for community based surveillance studies in rural areas where access to healthcare may be challenging.

No MeSH data available.


Related in: MedlinePlus

Participant distribution. Footnote: Four participants were retrospectively enrolled. EOD: Early Onset Disease; LOD: Late Onset Disease
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Fig1: Participant distribution. Footnote: Four participants were retrospectively enrolled. EOD: Early Onset Disease; LOD: Late Onset Disease

Mentions: Of the 108 participants enrolled with GBS culture confirmed disease, 93 met pre-defined eligibility criteria and were included in analyses (Analysis Population) (Fig. 1). Of the 15 exclusions, 10 were born outside the study hospital and five resided outside the study catchment area. Bangladesh did not identify any GBS cases over the study period.Fig. 1


Incidence and serotype distribution of invasive group B streptococcal disease in young infants: a multi-country observational study.

Rivera L, Sáez-Llorens X, Feris-Iglesias J, Ip M, Saha S, Adrian PV, Madhi SA, Boudville IC, Cunnington MC, Casellas JM, Slobod KS - BMC Pediatr (2015)

Participant distribution. Footnote: Four participants were retrospectively enrolled. EOD: Early Onset Disease; LOD: Late Onset Disease
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4591632&req=5

Fig1: Participant distribution. Footnote: Four participants were retrospectively enrolled. EOD: Early Onset Disease; LOD: Late Onset Disease
Mentions: Of the 108 participants enrolled with GBS culture confirmed disease, 93 met pre-defined eligibility criteria and were included in analyses (Analysis Population) (Fig. 1). Of the 15 exclusions, 10 were born outside the study hospital and five resided outside the study catchment area. Bangladesh did not identify any GBS cases over the study period.Fig. 1

Bottom Line: At 2.35 (95% CI: 1.74-3.18) cases per 1000 live births, the incidence of early onset GBS disease (EOD) was highest in the Dominican Republic, compared with 0.76 (95% CI: 0.41-1.39) in Hong Kong and 0.77 (95% CI: 0.44-1.35) in Panama, while no cases were identified in Bangladesh.The failure to identify GBS cases in Bangladesh highlights a need to better understand the contribution of population, healthcare and surveillance practice to variation in reported incidence.Overall, the identified disease burden and serotype distribution support the need for effective prevention methods in these populations, and the need for community based surveillance studies in rural areas where access to healthcare may be challenging.

View Article: PubMed Central - PubMed

Affiliation: Hospital Maternidad Nuestra Señora de la Altagracia, Santo Domingo, Dominican Republic. lrp@claro.net.do.

ABSTRACT

Background: Group B Streptococcus (GBS) is a leading cause of serious infection in very young infants. Robust incidence data from many geographic regions, including Latin America and Asia, are however lacking.

Methods: A multicenter, hospital-based observational study was performed in Panama, Dominican Republic, Hong Kong and Bangladesh. All represented urban, tertiary referral hospitals, except Bangladesh. GBS cases (microbiological isolation from normally sterile sites in infants aged 0-89 days) were collected over 12 months.

Results: At 2.35 (95% CI: 1.74-3.18) cases per 1000 live births, the incidence of early onset GBS disease (EOD) was highest in the Dominican Republic, compared with 0.76 (95% CI: 0.41-1.39) in Hong Kong and 0.77 (95% CI: 0.44-1.35) in Panama, while no cases were identified in Bangladesh. Over 90% of EOD cases occurred on the first day of life, with case fatality ratios ranging from 6.7% to 40%, varying by center, age of onset and clinical presentation. Overall, 90% of GBS (EOD and late onset disease) was due to serotypes Ia, Ib and III.

Conclusions: The incidence rate of early onset GBS infection reported in Dominican Republic was not dissimilar from that described in the United States prior to screening and intrapartum antibiotic prophylaxis, while the incidence in Hong Kong was higher than previously reported in the Asian region. The failure to identify GBS cases in Bangladesh highlights a need to better understand the contribution of population, healthcare and surveillance practice to variation in reported incidence. Overall, the identified disease burden and serotype distribution support the need for effective prevention methods in these populations, and the need for community based surveillance studies in rural areas where access to healthcare may be challenging.

No MeSH data available.


Related in: MedlinePlus