A survey of the incidence of neonatal sepsis by group B Streptococcus during a decade in a Brazilian maternity hospital

Abstract

Group B Streptococcus (GBS) is the main etiological agent of neonatal sepsis in developed countries, however there is no detailed information on its incidence in Brazil. We registered the incidence and lethality of GBS infection in a Brazilian private maternity hospital from April 1991 to March 2000. Maternal risk factors contributing to neonatal infections were also scored. The rate of infection was determined by checking for GBS in the blood and liquor of symptomatic neonates within 72 hours of birth. Sepsis and/or early onset meningitis were diagnosed in 43 neonates (32 cases in blood, 1in liquor and 10 in blood and liquor). The overall incidence was 0.39 per thousand neonates and remained quite constant throughout the period, ranging from 0.25-0.63. Septic shock occurred in 33 neonates within 1 to 36 hours of birth (mean 15 hours). Among those patients, 26 (60%) died between the 5th and the 85th hour after birth. Maternal risk factors, according to CDC criteria, included: gestational age below 37 weeks in 26 cases (60%), amniorrhexis equal or superior to 18 hours in 7 cases (16%), and maternal temperature equal or superior to 38(o)C in 4 cases (9%). None of the mothers had received prophylactic antibiotics during labor nor were urine, rectal or vaginal swabs screened for GBS. Although the incidence of GBS infection in the population in this study was lower than that found in developed countries, its rate of mortality was higher. The death rate could be reduced through recognition of the risk factors and prophylactic antibiotics during labor.

Detection of Group B Streptococcus in Brazilian pregnant women and antimicrobial susceptibility patterns

“…This was the motivation for this study involving Even considering the different rates of GBS infection according to the methodological approach used in this study, 9.5% and 32.6%, both values of prevalence are in agreement with literature data, which point to a prevalence range of 3-41% (13,26,27,32,33,35). This worldwide variability is related to different sociocultural, geographic, climatic, biological and methodological determinants.…”

“…The rates of GBS-colonized pregnant women range worldwide from 3% to 41% (13,26,32,33,35). Brazilian authors have found colonization rates from 5% to 25% in regional studies (3,22,23,26,29,30).…”

Prevalence of Group B Streptococci Colonization in Georgian Pregnant Women: Community Based Cross Sectional Study.

“…The overall prevalence for GBS colonization varies different countries is reported 5-40% depending on the different regions of the world [11] Our data is close to the studies: Grimwood et al [12] from New Zealand have reported 22%, while Joachim et al have reported the prevalence of 23% for GBS colonization. [13] Colonization rate reported was 27.6% in Portugal [14] 4.7% in India [15] and 20% in Taiwan.…”

Group B streptococcal disease in infants aged younger than 3 months: systematic review and meta-analysis

“…The Americas Martin et al 41 Vaciloto et al 42 Bell et al 43 Trotman et al 44 Castrodale et al 45 Chen et al 46 Hyde et al 47 Mayor-Lynn et al 48 Phares et al 49 Puopolo et al 50 CDC et al 51 Stoll et al 52 CDC et al 53 Brooks et al 54 Cordero et al 55 Jordan et al 56 Subtotal (I 2 =97·4%, p=0·000)…”