Neurodevelopmental Impairment in Children After Group B Streptococcal Disease Worldwide: Systematic Review and Meta-analyses

Kohli-Lynch, Maya; Russell, Neal; Seale, Anna C.; Dangor, Ziyaad; Tann, Cally J; Baker, Carol J.; Bartlett, Linda; Cutland, Clare; Gravett, Michael G.; Heath, Paul T; Ip, Margaret; Doare, Kirsty Le; Madhi, Shabir A.; Rubens, Craig E.; Saha, Samir K.; Schrag, Stephanie J.; Meulen, Ajoke Sobanjo-ter; Vekemans, Johan; O’Sullivan, Catherine; Nakwa, Firdose; Hamouda, H. Ben; Soua, H.; Giorgakoudi, Kyriaki; Ladhani, Shamez; Lamagni, Theresa; Rattue, Hilary; Trotter, Caroline; Lawn, Joy E

doi:10.1093/cid/cix663

Cited by 156 publications

(146 citation statements)

References 47 publications

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“…Mortality is also not the only outcome which should be considered. Neurodisability is a potentially preventable consequence of severe sepsis but much more difficult to assess because of the difficulties associated with long-term follow-up 21…”

Section: Discussionmentioning

confidence: 99%

Towards understanding global patterns of antimicrobial use and resistance in neonatal sepsis: insights from the NeoAMR network

Bielicki

Ahmed

et al. 2019

Arch Dis Child

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ObjectiveTo gain an understanding of the variation in available resources and clinical practices between neonatal units (NNUs) in the low-income and middle-income country (LMIC) setting to inform the design of an observational study on the burden of unit-level antimicrobial resistance (AMR).DesignA web-based survey using a REDCap database was circulated to NNUs participating in the Neonatal AMR research network. The survey included questions about NNU funding structure, size, admission rates, access to supportive therapies, empirical antimicrobial guidelines and period prevalence of neonatal blood culture isolates and their resistance patterns.Setting39 NNUs from 12 countries.PatientsAny neonate admitted to one of the participating NNUs.InterventionsThis was an observational cohort study.ResultsThe number of live births per unit ranged from 513 to 27 700 over the 12-month study period, with the number of neonatal cots ranging from 12 to 110. The proportion of preterm admissions <32 weeks ranged from 0% to 19%, and the majority of units (26/39, 66%) use Essential Medicines List ‘Access’ antimicrobials as their first-line treatment in neonatal sepsis. Cephalosporin resistance rates in Gram-negative isolates ranged from 26% to 84%, and carbapenem resistance rates ranged from 0% to 81%. Glycopeptide resistance rates among Gram-positive isolates ranged from 0% to 45%.ConclusionAMR is already a significant issue in NNUs worldwide. The apparent burden of AMR in a given NNU in the LMIC setting can be influenced by a range of factors which will vary substantially between NNUs. These variations must be considered when designing interventions to improve neonatal mortality globally.

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Section: Discussionmentioning

confidence: 99%

Towards understanding global patterns of antimicrobial use and resistance in neonatal sepsis: insights from the NeoAMR network

Bielicki

Ahmed

et al. 2019

Arch Dis Child

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“…In a recent study of GBS meningitis survivors, 44% developed long-term neurodevelopmental impairment, including cerebral palsy/spasticity and seizures. However, the effects of GBS infections without meningitis on long-term neurodevelopment and intellectual disability remain unclear 17…”

Section: Discussionmentioning

confidence: 99%

“…Considering its severity, there is limited recent information on the long-term outcomes of survivors of GBS infection in this era of intrapartum antibiotic prophylaxis 10. Recent information on the outcomes of infants with GBS infections has concentrated on GBS meningitis, and most reports are from the 1980s 11–17. Our study aimed to characterise the long-term health outcomes of children with GBS infection by linking birth, hospitalisation and mortality data up to the age of 11 years.…”

Section: Introductionmentioning

confidence: 99%

Long-term outcomes after group B streptococcus infection: a cohort study

et al. 2018

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“…[1][2][3] Infant invasive GBS disease is classified as early-onset disease (EOD) if it occurs during the first 6 days of life or late-onset disease (LOD) if it develops 7 or more days after birth. The worldwide burden of infant and maternal GBS disease is substantial, [4][5][6][7][8][9][10][11][12][13] and efforts are under-way to develop vaccines as a preventive measure to replace or supplement antenatal screening and intrapartum antibiotics effective against early but not late-onset disease. [14][15][16][17] EOD arises from vertical transmission from a GBS colonized mother to her baby during or just before birth, with clinical signs occurring within 48 h in more than 90% of cases.…”

Section: Introductionmentioning

confidence: 99%

Hospital clusters of invasive Group B Streptococcal disease: A systematic review

Collin

Lamb

Jauneikaite

et al. 2019

Journal of Infection

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Group B streptococcal disease Adult Neonatal Outbreak Cluster Healthcare-associated infection Systematic review s u m m a r y Objectives: To characterize outbreaks of invasive Group B Streptococcal (iGBS) disease in hospitals.Methods: Systematic review using electronic databases to identify studies describing iGBS outbreaks/clusters or cross-infection/acquisition in healthcare settings where 'cluster' was defined as ≥2 linked cases. PROSPERO CRD42018096297. Results: Twenty-five references were included describing 30 hospital clusters (26 neonatal, 4 adult) in 11 countries from 1966 to 2019. Cross-infection between unrelated neonates was reported in 19 clusters involving an early-onset ( < 7 days of life; n = 3), late-onset (7-90 days; n = 13) index case or colonized infant ( n = 3) followed by one or more late-onset cases (median serial interval 9 days (IQR 3-17, range 0-50 days, n = 45)); linkage was determined by phage typing in 3 clusters, PFGE/MLST/PCR in 8, WGS in 4, non-molecular methods in 4. Postulated routes of transmission in neonatal clusters were via clinical personnel and equipment, particularly during periods of crowding and high patient-to-nurse ratio. Of 4 adult clusters, one was attributed to droplet spread between respiratory cases, one to handling of haemodialysis catheters and two unspecified. Conclusions: Long intervals between cases were identified in most of the clusters, a characteristic which potentially hinders detection of GBS hospital outbreaks without enhanced surveillance supported by genomics.

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Neurodevelopmental Impairment in Children After Group B Streptococcal Disease Worldwide: Systematic Review and Meta-analyses

Abstract: Group B Streptococcus (GBS) is a leading cause of invasive disease in infants, causing mortality and neurodevelopmental impairment (NDI) in survivors. This article estimates the percentage of survivors of infant GBS disease with NDI.

Cited by 156 publications

References 47 publications

Towards understanding global patterns of antimicrobial use and resistance in neonatal sepsis: insights from the NeoAMR network

Towards understanding global patterns of antimicrobial use and resistance in neonatal sepsis: insights from the NeoAMR network

Long-term outcomes after group B streptococcus infection: a cohort study

Hospital clusters of invasive Group B Streptococcal disease: A systematic review

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