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

BMC Pediatrics

Karen S. Slobod⁹  Javier M. Casellas⁹  Marianne C. Cunnington⁶  Irving C. Boudville⁹  Shabir A. Madhi²  Peter V. Adrian¹  Samir Saha⁷  Margaret Ip³  Jesus Feris-Iglesias⁴  Xavier Sáez-Llorens⁵  Luis Rivera⁸ 

[1] Medical Research Council Respiratory and Meningeal Pathogens Research Unit, University of the Witwatersrand, Johannesburg, South Africa;National Institute for Communicable Diseases, Sandringham, South Africa;Department of Microbiology, Chinese University of Hong Kong, Hong Kong, SAR, China;Hospital Infantil Dr. Robert Reid Cabral, Santo Domingo, República Dominicana;Hospital del Niño and the School of Medicine of the University of Panama, Panama City, Panama;Global Development, Novartis Vaccines and Diagnostics, Frimley Business Park, Frimley, Camberley GU16 7SR, Surrey, UK;Department of Microbiology, Bangladesh Institute of Child Health, Dhaka Shishu Hospital, Dhaka, Bangladesh;Hospital Maternidad Nuestra Señora de la Altagracia, Santo Domingo, Dominican Republic;Novartis Vaccines and Diagnostics Inc., Cambridge, MA, USA

关键词: Latin America;    Asia;    Serotype distribution;    Incidence;    Group B streptococcal disease;   

Others  :  1231125
DOI  :  10.1186/s12887-015-0460-2

 received in 2014-05-16, accepted in 2015-09-22,  发布年份 2015

【 摘 要 】

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.

【 授权许可】

   
2015 Rivera et al.

【 图 表 】

Fig. 1.

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