Incidence of neonatal sepsis after universal antenatal culture‐based screening of group B streptococcus and intrapartum antibiotics: A multicentre retrospective cohort study

Chan, Ying Tze Viola; Lau, Shun; Hui, Shuk Yi Annie; Ma, Teng; Kong, Choi Wah; Kwong, Lee Ting; Chan, Diana Man Ka; Lee, Diana; Mok, Sau Lan; Ma, Vinci; Lo, Y.C.; Leung, Kwok; Leung, Wing Cheong

doi:10.1111/1471-0528.17279

Cited by 5 publications

(3 citation statements)

References 25 publications

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“…The findings from our review are similar to the findings of the review run by Miyairi et al [13] and highlight the crucial role of vertical transmission in the pathophysiology of the disease and the invasive nature of GAS disease, especially in cases of early perinatal infection. This resembles the cases of neonatal GBS infection where maternal testing and prophylaxis during labor have led to a significant decrease in the disease frequency [43,44].…”

Section: Discussionmentioning

confidence: 59%

Group A Streptococcus Infection in Neonatal Population: A Systematic Review of The Literature

Sokou,

Filippatos,

Daniil

et al. 2023

JCM

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(1) Background: The importance of group A streptococcus (GAS) infection severity has been recognized in children and adults. However, to our knowledge, there have been no systematic reviews or pooled assessments of the incidence and outcome of invasive GAS (iGAS) disease in neonates, a potentially high-risk population. Therefore, we performed a systematic review of available data regarding the risk factors, clinical presentation, and outcome of GAS infection in neonates. (2) Methods: An electronic search of the existing literature was carried out during the period July 2023–September 2023 in the PubMed and Scopus databases, considering studies referring to GAS infection in the neonatal population. (3) Results: Overall, 39 studies met all the inclusion criteria and were included in this review, evaluating data from 194 neonates. Unfortunately, there were a lot of missing data among the retrieved studies. Our systematic review highlighted the presence of differences with regards to clinical presentation, infection sites, and outcome of GAS invasive disease between neonates with early-onset (EOS) or late-onset sepsis (LOS). Common characteristics of EOS included respiratory distress, rapid deterioration, and high mortality rate irrespective of the infection site, while rash, gastrointestinal tract symptoms, and fever appeared to be the most frequent symptoms/clinical signs and manifestations of LOS disease. The management of severe invasive iGAS disease consists mainly of specific antimicrobial treatment as well as supportive care with fluids and electrolyte supplementation, minimizing or counteracting the effects of toxins. Furthermore, a mortality rate of approximately 14% was recorded for iGAS disease in the total of all studies’ neonates. (4) Conclusions: Although iGAS is a rare entity of neonatal infections, the potential severity of the disease and the rapid deterioration requires the development of quick analysis methods for the detection of GAS allowing the prompt diagnosis and administration of the indicated antibiotic treatment. Furthermore, given the exceptional risk for both the pregnant woman and the neonate, it is very important to raise awareness and create easily accessible guidelines that could facilitate the prevention and management of maternal as well as the subsequent neonatal severe iGAS disease.

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Section: Discussionmentioning

confidence: 59%

Group A Streptococcus Infection in Neonatal Population: A Systematic Review of The Literature

Sokou,

Filippatos,

Daniil

et al. 2023

JCM

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“…In the United States, the use of IAP coincided with a decline in reported EOGBSS rates, from 0.7/1000 live births (LB) in 1997 [8] to 0.2/1000 LB in 2020 [9]. A similar reduction has been reported from around the world [10,11,12]. Compared to the risk-based approach for maternal IAP, universal screening of mothers is signi cantly more effective in preventing EOGBSS [13,14].…”

Section: Introductionmentioning

confidence: 79%

Incidence and outcomes of Neonatal Group B Streptococcal Sepsis in Qatar-A multi-center study

Salim,

Vellamgot,

Salameh

et al. 2023

Preprint

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Background Group B Streptococcus (GBS) is the most common cause of neonatal early onset sepsis in term infants and a major cause of late onset sepsis in both term and preterm infants. Aim to estimate the incidence of GBSS among neonates born in Qatar between July 2015 and June 2020 (5 years). A secondary aim was to describe the outcomes of the affected babies. Materials and Methods A retrospective chart review of all neonates born during the study period was performed with the help of medical records departments of the four main maternity hospitals in Qatar, where > 90% of the births occurred. Results From 123878 live births, 113 babies grew GBS in blood culture during the first 90 days. 72 cases of early-onset GBS sepsis (EOGBSS) and 41 cases of late-onset GBS sepsis (LOGBSS) were identified. The estimated incidence of EOGBSS and LOGBSS was 0.58/1000 live births (95% CI 0.46–0.73) and 0.33/1000 live births (95% CI 0.24–0.45) respectively. The overall mortality was 7%, and the chart review identified severe neurodisability among at least 11% of survivors. Conclusion The incidences of EOGBSS and LOGBSS in Qatar are 0.58/1000 live births (LB) and 0.33/1000 LB, respectively. The relatively high incidence of EOGBSS probably reflects the high rate of carrier state among pregnant mothers. We did not observe any significant change in incidence after introducing the universal maternal screening for GBS. The overall mortality was similar to previously published data. Further prospective studies are recommended.

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“…Its clinical manifestations range from mild illness to severe respiratory disease, meningitis, and neonatal sepsis. Late-onset neonatal GBS disease occurs after the 7th day of life and is characterized by clinical signs of bacteremia, meningitis, and other focal infections, such as osteomyelitis, septic arthritis, skin and soft tissue infections, urinary tract infections, and pneumonia (2,3).…”

Section: Introductionmentioning

confidence: 99%

Membrane stripping in group B streptococcus carriers does not impede adequate intrapartum antibiotic prophylaxis: a retrospective study

Kabiri,

Paltiel,

Ofek-shlomai

et al. 2024

Front. Med.

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ObjectiveMembrane stripping in group B streptococcus (GBS) carriers poses an increased risk of inadequate antibiotic prophylaxis, potentially due to accelerated labor, thereby potentially impacting the management of GBS colonization during delivery. We compared the adequacy of intrapartum antibiotic prophylaxis between pregnant women colonized with GBS, who underwent membrane stripping and those who did not. The study aimed to determine whether the performance of membrane stripping, by potentially shortening labor duration, increases the risk of inadequate antibiotic prophylaxis dispensation.Study designA retrospective cohort study was conducted on GBS screen-positive women with a full-term singleton pregnancy in cephalic presentation, who were eligible for vaginal delivery. The exposed group consisted of women who underwent membrane stripping, while the unexposed group consisted of women who did not undergo membrane stripping. The primary outcome was defined as inadequate duration of antibiotic prophylaxis during labor, wherein less than 4 h of beta-lactam antibiotics were administered prior to delivery. Neonatal outcome was compared between the groups.ResultsThis retrospective cohort study comprised 1,609 women, with 129 in the exposed group (stripping group) and 1,480 in the unexposed group (no stripping group). Adequate intrapartum antibiotic prophylaxis was received by 64.3% (83/129) of the exposed group, compared to 46.9% (694/1,480) of the unexposed group (p = 0.003). Membrane stripping was associated with increased odds of receiving adequate prophylaxis (OR 1.897, 95% CI 1.185–3.037, p = 0.008). After excluding women who presented to the labor ward in active labor and delivered in less than 4 h, both the exposed and unexposed groups had similarly high rates of adequate intrapartum antibiotic prophylaxis (87.5% vs. 85.8%, respectively). No significant difference was observed in adverse neonatal outcomes between the groups.ConclusionThe provision of membrane stripping did not impede adequate intrapartum antibiotic prophylaxis and was correlated with a higher rate of sufficient prophylaxis in comparison to non-swept patients. These observations suggest that membrane stripping can be considered a safe option for ensuring adequate antibiotic prophylaxis in women colonized with GBS.

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Incidence of neonatal sepsis after universal antenatal culture‐based screening of group B streptococcus and intrapartum antibiotics: A multicentre retrospective cohort study

Cited by 5 publications

References 25 publications

Group A Streptococcus Infection in Neonatal Population: A Systematic Review of The Literature

Group A Streptococcus Infection in Neonatal Population: A Systematic Review of The Literature

Incidence and outcomes of Neonatal Group B Streptococcal Sepsis in Qatar-A multi-center study

Membrane stripping in group B streptococcus carriers does not impede adequate intrapartum antibiotic prophylaxis: a retrospective study

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