Clinical and Molecular Epidemiology of Invasive Group BStreptococcusDisease among Infants, China

Abstract

Invasive group B Streptococcus (GBS) remains a leading cause of illness and death among infants globally. We conducted prospective and retrospective laboratory-based surveillance of GBS-positive cultures from infants <3 months of age in 18 hospitals across China during January 1, 2015–December 31, 2017. The overall incidence of GBS was 0.31 (95% CI 0.27–0.36) cases/1,000 live births; incidence was 0–0.76 cases/1,000 live births across participating hospitals. The case-fatality rate was 2.3%. We estimated 13,604 cases of GBS and 1,142 GBS–associated deaths in infants <90 days of age annually in China. GBS isolates were most commonly serotype III (61.5%) and clonal complex 17 (40.6%). Enhanced active surveillance and implementation of preventive strategies, such as maternal GBS vaccination, warrants further investigation in China to help prevent these infections.

Predominance of III/ST19 and Ib/ST10 Lineages With High Multidrug Resistance in Fluoroquinolone-Resistant Group B Streptococci Isolates in Which a New Integrative and Conjugative Element Was Identified

“…Records were considered as the same episode if specimens were taken within 7 days and showed resistance to the same antibiotics and were thus merged accordingly to form a single record. Sampling, laboratory procedures, and identification of GBS were performed as previously described (Ji et al, 2019 ; Li et al, 2019 ).…”

Neonatal sepsis: within and beyond China

“…[ 23 ] Based on so far the largest population-based surveillance study for GBS disease burden from 18 urban tertiary hospitals across 16 Chinese provinces (2015–2017), the overall incidence of invasive GBS disease in infants ≤3 months of life was estimated to be 0.31 (95% CI 0.27–0.36) cases per 1000 LBs, ranging from 0 to 76 cases per 1000 LBs across participating hospitals. [ 24 ] The incidence of early- and late-onset GBS disease was 0.18 (95% CI 0.15–0.22) and 0.13 (95% 0.11–0.16) per 1000 LBs, respectively. [ 24 ] The majority (76.6%) of invasive GBS disease occurred in term infants, and only 13.2% of GBS-case mothers received GBS screening during pregnancy.…”

“…[ 24 ] The incidence of early- and late-onset GBS disease was 0.18 (95% CI 0.15–0.22) and 0.13 (95% 0.11–0.16) per 1000 LBs, respectively. [ 24 ] The majority (76.6%) of invasive GBS disease occurred in term infants, and only 13.2% of GBS-case mothers received GBS screening during pregnancy. [ 24 ] Similar to the UK, five serotypes (Ia, Ib, II, III, and V) accounted for the majority of GBS invasive cases in the mainland of China, and isolated GBS strains were most commonly III serotype and ST 17.…”

“…[ 24 ] The majority (76.6%) of invasive GBS disease occurred in term infants, and only 13.2% of GBS-case mothers received GBS screening during pregnancy. [ 24 ] Similar to the UK, five serotypes (Ia, Ib, II, III, and V) accounted for the majority of GBS invasive cases in the mainland of China, and isolated GBS strains were most commonly III serotype and ST 17. [ 23 , 24 ] Due to population characteristics and sociocultural background, the actual rate of maternal GBS colonization and neonatal GBS diseases in China may differ greatly from those reported in industrialized countries, and are probably much lower based on current knowledge.…”

“…[ 24 ] Similar to the UK, five serotypes (Ia, Ib, II, III, and V) accounted for the majority of GBS invasive cases in the mainland of China, and isolated GBS strains were most commonly III serotype and ST 17. [ 23 , 24 ] Due to population characteristics and sociocultural background, the actual rate of maternal GBS colonization and neonatal GBS diseases in China may differ greatly from those reported in industrialized countries, and are probably much lower based on current knowledge. Unresolved issues remain as to whether GBS screening and prevention protocols should be incorporated in China, and if so, what kind of strategies.…”