Early‐onset neonatal group B streptococcus sepsis following national risk‐based prevention guidelines

Darlow, Brian A; Voss, Lesley; Lennon, Diana; Grimwood, Keith

doi:10.1111/ajo.12378

Cited by 35 publications

(27 citation statements)

References 22 publications

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“…Two studies 37,41 investigated incidences of 'clinical sepsis', too, but those were not included as cases in our review. Secondary outcomes in the studies included mortality 12,36,38,45,46 or an audit of adherence to policy 27,43,45…”

Section: Discussionmentioning

confidence: 99%

“…A total of 17 observational studies could be included in the systematic review. Data for the meta-analysis could be extracted from 14 studies 12,[34][35][36][37][38][39][40][41][42][43][44][45][46] . Additional data for the meta-analysis were kindly provided by the authors of one study.…”

Section: Study Selectionmentioning

confidence: 99%

“…35,43,45 In analysis 2 (any policy versus no policy) the introduction of universal screening 26,35,38,43,45 was investigated in five studies and the introduction of risk-based protocols in seven. 12,13,[35][36][37]43,45 (Tables 1 and 2).…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Bias post-intervention was low or moderate in most studies. All studies with historical controls, 12,13,26,27,[34][35][36][37][38][39]42,43,45 except one using a cross-over design, 42 suffered from bias due to healthcare improvement over time: 'performance bias'. All studies had possible problems due to missing data, resulting from underreported cases.…”

Section: Risk Of Bias Within Studiesmentioning

confidence: 99%

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Universal screening versus risk‐based protocols for antibiotic prophylaxis during childbirth to prevent early‐onset group B streptococcal disease: a systematic review and meta‐analysis

Hasperhoven

Al‐Nasiry

Bekker

et al. 2020

BJOG

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Background Early‐onset group B streptococcal (EOGBS) disease (including sepsis, meningitis, and pneumonia) causes significant morbidity and mortality in newborn infants worldwide. Antibiotic prophylaxis can prevent vertical streptococcal transmission, yet no uniform criteria exist to identify eligible women for prophylaxis. Some guidelines recommend universal GBS screening to pregnant women in their third trimester (screening‐based protocol), whereas others employ risk‐based protocols. Objectives To compare the effectiveness of screening‐based versus risk‐based protocols in preventing EOGBS disease. Search strategy Key words for the database searches included GBS, Streptococcus agalactiae, pregnancy, screening, culture‐based, risk‐based. Selection criteria Studies were included if they investigated EOGBS disease incidence in newborn infants and compared screening or risk‐based protocols with each other or with controls. Data collection and analysis Risk ratios (RR) and 95% confidence intervals (CI) were determined using Mantel‐Haenszel analyses with random effects. Main results Seventeen eligible studies were included. In this meta‐analysis, screening was associated with a reduced risk for EOGBS disease compared either with risk‐based protocols (ten studies, RR 0.43, 95% CI 0.32–0.56) or with no policy (four studies, RR 0.31, 95% CI 0.11–0.84). Meta‐analysis could not demonstrate a significant effect of risk‐based protocols versus no policy (seven studies, RR 0.86, 95% CI 0.61–1.20). In studies reporting on the use of antibiotics, screening was not associated with higher antibiotic administration rates (31 versus 29%). Conclusions Screening‐based protocols were associated with lower incidences of EOGBS disease compared with risk‐based protocols, while not clearly overexposing women to antibiotics. This information is of relevance for future policymaking. Tweetable abstract Meta‐analysis: general screening is associated with lower rates of early‐onset group B strep. neonatal sepsis compared with risk‐based protocols.

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Section: Discussionmentioning

confidence: 99%

Section: Study Selectionmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

Section: Risk Of Bias Within Studiesmentioning

confidence: 99%

See 2 more Smart Citations

Universal screening versus risk‐based protocols for antibiotic prophylaxis during childbirth to prevent early‐onset group B streptococcal disease: a systematic review and meta‐analysis

Hasperhoven

Al‐Nasiry

Bekker

et al. 2020

BJOG

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“…The isolate sampling framework for this study has been described previously [5]. Isolates were derived from a nationwide surveillance study of bacterial meningitis and infant bacteraemia conducted by the Netherlands Reference Laboratory for Bacterial Meningitis.…”

Section: Methodsmentioning

confidence: 99%

Temporal population structure of invasive Group BStreptococcusduring a period of rising disease incidence shows expansion of a CC17 clone

Jamrozy

Goffau

et al. 2018

Preprint

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21 Group B Streptococcus (GBS) is a major cause of neonatal invasive disease worldwide. In 22 the Netherlands, the incidence of the disease increased, despite the introduction of prevention 23 guidelines in 1999. This was accompanied by changes in pathogen genotype distribution, 24 with a significant increase in the prevalence of isolates belonging to clonal complex (CC) 17.25 To better understand the mechanisms of temporal changes in the epidemiology of GBS 26 genotypes that correlated with the rise in disease incidence, we applied whole genome 27 sequencing (WGS) to study a national collection of invasive GBS isolates. A total of 1345 28 isolates from patients aged 0 -89 days and collected between 1987 and 2016 in the 29 Netherlands were sequenced and characterised. The GBS population contained 5 major 30 lineages representing CC17 (39%), CC19 (25%), CC23 (18%), CC10 (9%), and CC1 (7%).31 There was a significant rise in the prevalence of isolates representing CC17 and CC23 among 32 cases of early-and late-onset disease, due to expansion of discrete sub-lineages. The most 33 prominent was shown by a CC17 sub-lineage, identified here as CC17-1A, which 34 experienced a major clonal expansion at the end of the 1990s. The CC17-1A expansion 35 correlated with the emergence of a novel phage carrying a gene encoding a putative adhesion 36 protein, named here StrP. The first occurrence of this phage (designated phiStag1) within the 37 collection in 1997, was followed by multiple, independent acquisitions by CC17 and parallel 38 clonal expansions of CC17-1A and another cluster, CC17-1B. The CC17-1A clone was 39 identified in external datasets, and represents a globally distributed invasive sub-lineage of 40 CC17. Our work describes how a sudden change in the epidemiology of specific GBS sub-41 lineages, in particular CC17-1A, correlates with the rise in the disease incidence, and 42 indicates a putative key role of a novel phage in driving the expansion of this CC17 clone. 43 3 44 Author summary45 Group B Streptococcus (GBS) is a commensal organism of the gastrointestinal and 46 genitourinary tracts. However, it is also an opportunistic pathogen and a major cause of 47 neonatal invasive disease, which can be classified into early-onset (0 -6 days of life) or late-48 onset (7 -89 days of life). Current disease prevention strategy involves intrapartum antibiotic 49 prophylaxis (IAP), which aims to prevent the transmission of GBS from mother to baby 50 during labour. Many developed countries adapted national IAP guidelines. In the 51 Netherlands, these were introduced in 1999. However, the incidence of GBS disease 52 increased after IAP introduction. In this study we applied whole genome sequencing to 53 characterise a nationwide collection of invasive GBS from cases of neonatal disease that 54 occurred between 1987 and 2016. Analysis of GBS population structure involving 55 phylogenetic partitioning of individual lineages revealed that the rise in disease incidence 56 involved the expansion of specific clusters from two ma...

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Multicenter Performance Evaluation of the Revogene® GBS DS Real-Time PCR Assay for Group B Streptococcus Detection During Labor

d'Otreppe¹,

Lefèvre²,

Meex

et al. 2023

Mol Diagn Ther

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Early‐onset neonatal group B streptococcus sepsis following national risk‐based prevention guidelines

Abstract: Ten years after a similar survey and five years after promoting a single, risk-based prevention protocol nationally, the incidence of early-onset GBS disease in New Zealand has more than halved, but opportunities remain to further reduce the rate.

Cited by 35 publications

References 22 publications

Universal screening versus risk‐based protocols for antibiotic prophylaxis during childbirth to prevent early‐onset group B streptococcal disease: a systematic review and meta‐analysis

Universal screening versus risk‐based protocols for antibiotic prophylaxis during childbirth to prevent early‐onset group B streptococcal disease: a systematic review and meta‐analysis

Temporal population structure of invasive Group BStreptococcusduring a period of rising disease incidence shows expansion of a CC17 clone

Multicenter Performance Evaluation of the Revogene® GBS DS Real-Time PCR Assay for Group B Streptococcus Detection During Labor

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