No abstract

No 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.

No abstract

Internal instability is a form of internal erosion in broadly-graded cohesionless soils in which fine particles can be eroded at lower hydraulic gradients than predicted by classical theory for piping or heave. A key mechanism enabling internal instability is the formation of a stress-transmitting matrix dominated by the coarse particles that leaves the finer particles under lower effective stress. In this study discrete element modeling is used to analyze the fabric and effective stress distribution within idealized gap-graded samples with varying potential for internal stability. The reduction in stress within the finer fraction of the materials is directly quantified from grain-scale data. The particle size distribution, percentage finer fraction and relative density are found to influence the stress distribution. In particular, effective stress transfer within a critical finer fraction between 24% and 35% is shown to be highly sensitive to relative density.

The predominant serotypes were III (n=258, 60%) and Ia (n=73, 17%); five serotypes (Ia, Ib, II, III, V) comprised 94% (n=377) of serotyped isolates (n=402). Interpretation: The incidence of invasive infant GBS disease in the UK and Ireland has increased since 2000-2001. The burden of EOD incidence has not declined despite the introduction of national prevention guidelines. New strategies for prevention are required.

No abstract

BackgroundEarly-onset group B streptococcal disease (EOGBS) occurs in neonates (days 0–6) born to pregnant women who are rectovaginally colonized with group B Streptococcus (GBS), but the risk of EOGBS from vertical transmission has not been systematically reviewed. This article, the seventh in a series on the burden of GBS disease, aims to estimate this risk and how it varies with coverage of intrapartum antibiotic prophylaxis (IAP), used to reduce the incidence of EOGBS.MethodsWe conducted systematic reviews (Pubmed/Medline, Embase, Latin American and Caribbean Health Sciences Literature (LILACS), World Health Organization Library Information System [WHOLIS], and Scopus) and sought unpublished data from investigator groups on maternal GBS colonization and neonatal outcomes. We included articles with ≥200 GBS colonized pregnant women that reported IAP coverage. We did meta-analyses to determine pooled estimates of risk of EOGBS, and examined the association in risk of EOGBS with IAP coverage.ResultsWe identified 30 articles including 20328 GBS-colonized pregnant women for inclusion. The risk of EOGBS in settings without an IAP policy was 1.1% (95% confidence interval [CI], .6%–1.5%). As IAP increased, the risk of EOGBS decreased, with a linear association. Based on linear regression, the risk of EOGBS in settings with 80% IAP coverage was predicted to be 0.3% (95% CI, 0–.9).ConclusionsThe risk of EOGBS among GBS-colonized pregnant women, from this first systematic review, is consistent with previous estimates from single studies (1%–2%). Increasing IAP coverage was linearly associated with decreased risk of EOGBS disease.