Epidemiology of invasive group B streptococcal disease in infants from urban area of South China, 2011–2014

Abstract

BackgroundGroup B Streptococcus (GBS) is a leading cause of morbidity and mortality in infants in both developed and developing countries. To our knowledge, only a few studies have been reported the clinical features, treatment and outcomes of the GBS disease in China. The severity of neonatal GBS disease in China remains unclear. Population-based surveillance in China is therefore required.MethodsWe retrospectively collected data of <3 months old infants with culture-positive GBS in sterile samples from three large urban tertiary hospitals in South China from Jan 2011 to Dec 2014. The GBS isolates and their antibiotic susceptibility were routinely identified in clinical laboratories in participating hospitals. Serotyping and multi-locus sequence typing (MLST) were also conducted for further analysis of the neonatal GBS disease.ResultsTotal 70 cases of culture-confirmed invasive GBS infection were identified from 127,206 live births born in studying hospitals, giving an overall incidence of 0.55 per 1000 live births (95% confidence interval [CI] 0.44–0.69). They consisted of 49 with early-onset disease (EOD, 0.39 per 1000 live births (95% CI 0.29–0.51)) and 21 with late-onset disease (LOD, 0.17 per 1000 live births (95% CI 0.11–0.25)). The incidence of EOD increased significantly over the studying period. Five infants (4 EOD and 1 LOD) died before discharge giving a mortality rate of 7.1% and five infants (7.1%, 2 EOD and 3 LOD) had neurological sequelae. Within 68 GBS isolates from GBS cases who born in the studying hospitals or elsewhere, serotype III accounted for 77.9%, followed by Ib (14.7%), V (4.4%), and Ia (2.9%). MLST analysis revealed the presence of 13 different sequence types among the 68 GBS isolates and ST-17 was the most frequent sequence type (63.2%). All isolates were susceptible to penicillin, ceftriaxone, vancomycin and linezolid, while 57.4% and 51.5% were resistant to erythromycin and clindamycin, respectively.ConclusionsThis study gains the insight into the spectrum of GBS infection in south China which will facilitate the development of the guidance for reasonable antibiotics usage and will provide evidence for the implementation of potential GBS vaccines in the future.Electronic supplementary materialThe online version of this article (10.1186/s12879-017-2811-0) contains supplementary material, which is available to authorized users.

Pathogens Responsible for Early-Onset Sepsis in Suzhou, China

“…In our study, the most frequent early-onset pathogens causing the infant infections were GBS and E. coli, which is consistent with the results from previous studies (8,10,11). Other pathogens were notably less frequent.…”

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

“…Our results indicated that serotype III was the most common type (61.2%). Other studies also have reported the comparable proportion of serotype III in China ( 7 , 22 – 24 ). In general, GBS serotype distributions were similar across regions of China, and were similar to findings for other countries, with serotype III dominating (61.5%) and serotypes Ia, Ib, II, III, and V causing 97% of invasive GBS disease ( 3 ).…”

“…GBS is associated with severe neonatal infection in some hospitals in China ( 7 , 12 – 16 ), but a paucity of generalizable data is available across the country. We conducted a large, multicenter study to evaluate the clinical and molecular epidemiology of invasive group B streptococcal disease among infants < 3 months of age in China.…”

“…Systematic reviews noted the paucity of data on GBS from Asia, including China, as a major data gap ( 2 – 6 ), highlighting the need for prospective population-based studies. A previous study by our group reported a GBS incidence rate of 0.55 (95% CI 0.44–0.69) cases/1,000 live births in 3 hospitals in the Guangdong Province of southern China during 2011–2014 ( 7 ). To improve on the generalizability of our earlier study, we undertook a multicenter population-based study at 18 sentinel hospitals across 16 provinces in China.…”

Epidemiology of group B streptococcal infection in pregnant women and diseased infants in mainland China

“…6,7 Several studies have reported 0.55e1.79 cases of neonatal GBS per 1000 live births, with a CFR of 6.45e7.1%. 8,9 Therefore, physicians should pay great attention to GBS infection, relevant research should be actively performed, and appropriate guidelines for the diagnosis and treatment of GBS should be formulated to prevent or reduce the incidence of neonatal GBS infection and improve maternal and infant outcomes.…”