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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

Serotype distribution by country and by center ((Analysis Population) for all GBS cases (a) for early onset disease (b) and late onset disease (c). Footnote: No late onset disease cases were recorded at Site 1 in the Dominican Republic as this was a maternity without a pediatric facility
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Fig2: Serotype distribution by country and by center ((Analysis Population) for all GBS cases (a) for early onset disease (b) and late onset disease (c). Footnote: No late onset disease cases were recorded at Site 1 in the Dominican Republic as this was a maternity without a pediatric facility

Mentions: Overall, 91 % of all GBS cases were due to serotypes Ia, Ib or III (87 % of all EOD; 100 % of all LOD; Fig. 2a). Serotype III alone was responsible for 40 % of EOD (Fig. 2b) and 85 % of LOD cases (Fig. 2c). Serotype distribution varied geographically. For EOD, serotype III predominated in Dominican Republic (38 %), while serotype Ia was most common in Panama (50 %) and in Hong Kong serotypes Ib and III were equally represented (40 % of disease each). For LOD, serotype III predominated in Panama and Dominican Republic (100 % and 83 % of cases respectively), while serotype Ib accounted for 40 % cases in Hong Kong. All fatal cases were serotype III. The serotype distribution differed between the two Dominican Republic hospital as one (maternity) captured only EOD cases and the second (pediatric) captured mainly LOD cases.Fig. 2


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)

Serotype distribution by country and by center ((Analysis Population) for all GBS cases (a) for early onset disease (b) and late onset disease (c). Footnote: No late onset disease cases were recorded at Site 1 in the Dominican Republic as this was a maternity without a pediatric facility
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

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

Fig2: Serotype distribution by country and by center ((Analysis Population) for all GBS cases (a) for early onset disease (b) and late onset disease (c). Footnote: No late onset disease cases were recorded at Site 1 in the Dominican Republic as this was a maternity without a pediatric facility
Mentions: Overall, 91 % of all GBS cases were due to serotypes Ia, Ib or III (87 % of all EOD; 100 % of all LOD; Fig. 2a). Serotype III alone was responsible for 40 % of EOD (Fig. 2b) and 85 % of LOD cases (Fig. 2c). Serotype distribution varied geographically. For EOD, serotype III predominated in Dominican Republic (38 %), while serotype Ia was most common in Panama (50 %) and in Hong Kong serotypes Ib and III were equally represented (40 % of disease each). For LOD, serotype III predominated in Panama and Dominican Republic (100 % and 83 % of cases respectively), while serotype Ib accounted for 40 % cases in Hong Kong. All fatal cases were serotype III. The serotype distribution differed between the two Dominican Republic hospital as one (maternity) captured only EOD cases and the second (pediatric) captured mainly LOD cases.Fig. 2

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