Prevention of early onset group B streptococcal disease by universal antenatal culture-based screening in all public hospitals in Hong Kong

Teresa, W. L.; Chan, V.; So, Cameron; Hui, Shuk Yi Annie; Lee, C. N.; Hui, Amelia P W; So, Po Lam; Kong, Cheol-Won; Fung, Barbara; Leung, Kwok‐Yin

doi:10.1080/14767058.2017.1300649

Cited by 23 publications

(35 citation statements)

References 18 publications

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“…GBS colonization rates in Chinese pregnant women have been reported to vary between regions. For example, the reported rate was 20% in Taiwan [10], 21.8% in Hong Kong [11], 7.1% in Beijing [12], and 36% in Shaanxi Province [13]. Worldwide, frequencies of maternal GBS colonization have been reported to range from 14–30% in developed countries [14] to 19% in the Sub-Saharan region [15] and 12–15% in India and Pakistan [16].…”

Section: Discussionmentioning

confidence: 99%

Group B Streptococcus Colonization in Late Pregnancy and Invasive Infection in Neonates in China: A Population-Based 3-Year Study

et al. 2019

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Background: As no population-based studies of group B Streptococcus (GBS) colonization rates in late pregnancy (at 35–37 weeks of gestation) have been conducted in China, the incidence of and risk factors for neonatal early-onset GBS disease (GBS-EOD) in China remains poorly understood. Objectives: To determine the GBS colonization rate in late pregnancy and neonatal GBS infection in Xiamen, China, and to assess the effectiveness of intrapartum antibiotic prophylaxis (IAP) for the prevention of neonatal GBS-EOD. Methods: A total of 49,908 pregnant women were enrolled between April 1, 2014 and March 31, 2017. Bacterial culture was used to diagnose GBS infection in both pregnant women and neonates. Women with GBS colonization received IAP during parturition or rupture of fetal membranes. Results: The GBS colonization rate was 13.89% (6,933/49,908); 50,772 neonates were born to 49,908 pregnant women, of whom 75 (1.48 per 1,000) were diagnosed with GBS-EOD. The incidence of GBS-EOD among neonates born to GBS-positive mothers (8.77‰; 62/7,068) was 29 times higher than that of neonates born to GBS-negative mothers (0.30‰; 13/43,704). Logistic regression analysis indicated that gestational bacteriuria, GBS disease in infants from previous pregnancies, and chorioamnionitis were risk factors for GBS-EOD (p = 0.007, p = 0.000, and p = 0.018, respectively). IAP effectively protected against neonatal GBS-EOD (p = 0.011). Conclusions: GBS colonization was detected in nearly 14% of late pregnant women. The IAP for reducing GBS-EOD was effective. Therefore, universal screening of maternal GBS and subsequent IAP for those with GBS colonization should be implemented in China.

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Section: Discussionmentioning

confidence: 99%

Group B Streptococcus Colonization in Late Pregnancy and Invasive Infection in Neonates in China: A Population-Based 3-Year Study

et al. 2019

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“…Eleven studies 27,34,35,[39][40][41][42][43][45][46][47] provided a direct comparison of screening-based versus risk-based protocols (analysis 1), of which three also studied incidences during 'no policy' periods. 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.…”

Section: Study Characteristicsmentioning

confidence: 99%

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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“…De los casos con SP hoy en día, en una experiencia italiana, cerca de 30 a 60% no recibe PAI porque no califica dentro de las indicaciones establecidas y de los que tienen indicación, apenas 15 a 50% la recibe correctamente 1 . Las principales causas de la no administración o administración incorrecta de la PAI son: parto precipitado, resistencia a eritromicina y clindamicina en mujeres gestantes alérgicas a β-lactámicos o la administración iniciada en un tiempo inferior a las 4 h previas al parto 7,13 . Este fracaso se estima que ocasiona entre 6-13 casos de SP, según un reciente estudio publicado en Hong Kong 13 .…”

Section: S Treptococcus Agalactiae (Comúnmente Denominadounclassified

“…Las principales causas de la no administración o administración incorrecta de la PAI son: parto precipitado, resistencia a eritromicina y clindamicina en mujeres gestantes alérgicas a β-lactámicos o la administración iniciada en un tiempo inferior a las 4 h previas al parto 7,13 . Este fracaso se estima que ocasiona entre 6-13 casos de SP, según un reciente estudio publicado en Hong Kong 13 .…”

Section: S Treptococcus Agalactiae (Comúnmente Denominadounclassified

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Infección neonatal y tamizaje universal para Streptococcus agalactiae (β-hemolítico del grupo B) a la mujer embarazada: Recomendación técnica

Sandoval

Cofré

Delpiano

et al. 2017

Rev. chil. infectol.

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Prevention of early onset group B streptococcal disease by universal antenatal culture-based screening in all public hospitals in Hong Kong

Abstract: Maternal GBS colonization rate was higher than previously reported, and varied with different risk populations. EOGBSD reduced after universal screening.

Cited by 23 publications

References 18 publications

Group B Streptococcus Colonization in Late Pregnancy and Invasive Infection in Neonates in China: A Population-Based 3-Year Study

Group B Streptococcus Colonization in Late Pregnancy and Invasive Infection in Neonates in China: A Population-Based 3-Year Study

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

Infección neonatal y tamizaje universal para Streptococcus agalactiae (β-hemolítico del grupo B) a la mujer embarazada: Recomendación técnica

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Prevention of early onset group B streptococcal disease by universal antenatal culture-based screening in all public hospitals in Hong Kong

Abstract: Maternal GBS colonization rate was higher than previously reported, and varied with different risk populations. EOGBSD reduced after universal screening.

Cited by 23 publications

References 18 publications

Group B Streptococcus Colonization in Late Pregnancy and Invasive Infection in Neonates in China: A Population-Based 3-Year Study

Group B Streptococcus Colonization in Late Pregnancy and Invasive Infection in Neonates in China: A Population-Based 3-Year Study

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

Infección neonatal y tamizaje universal para Streptococcus agalactiae (&#946;-hemolítico del grupo B) a la mujer embarazada: Recomendación técnica

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Infección neonatal y tamizaje universal para Streptococcus agalactiae (β-hemolítico del grupo B) a la mujer embarazada: Recomendación técnica