The Pediatric Investigators Collaborative Network on Infections in Canada (PICNIC) study of neonatal group B streptococcal infections in Canada

Abstract

OBJECTIVES:To determine the presentation and medical outcomes of neonatal group B streptococcus (GBS) disease in Canada, and describe maternal and obstetrical risk factors. DESIGN: Retrospective review of health records and laboratory databases using standardized data collection forms. SETTING: All neonates diagnosed with GBS infections in 1992 at 13 Canadian paediatric centres. RESULTS: A total of 105 infants meeting the criteria for neonatal GBS disease were identified. The majority of cases (78 or 74.3%) had earlyonset disease (EOD); 78.9% (60 of 76) of these cases presented within 24 h of delivery. Rates of EOD (less than seven days) varied from 0.44/1000 live births to 2.1/1000 live births, with an overall rate of 1.2/1000 live births. Pneumonia was the most common clinical illness (43.8%), followed by bacteremia without focus (23.8%) and meningitis (16.2%). At least one maternal risk factor for neonatal GBS disease was noted in 46 of 78 (59%) infants with EOD. A median of one dose (range one to 23 doses) of intrapartum antibiotics was given in 18 of 75 (24%) of the pregnancies. Overall, the mean gestational age at birth was 36.2±4.7 weeks, with 38 of 96 (39.6%) infants having a gestational age at birth younger than 37 weeks (31 of 73 [42.5%] EOD cases were born with a gestational age younger than 37 weeks). The median birth weight was 3099 g (range 610 g to 4830 g). Thirty of 94 (31.9%) infants had a birth weight less than 2500 g. Seventeen (16.2%) infants died. CONCLUSIONS: In 1992, neonatal GBS disease was a significant cause of morbidity and mortality in Canadian infants. More than half of the cases identified in this study could have been potentially preventable by the use of intrapartum antibiotics for women with known risk factors. There is a need for prospective studies to better define risk factors and preventative measures for neonatal GBS infections in Canada.

Multilocus Sequence Typing of Serotype III Group B Streptococcus and Correlation with Pathogenic Potential

“…Group B streptococcus (GBS) has been the major cause of bacterial sepsis and meningitis in newborns for the past 3 decades [1][2][3][4][5][6][7]. Antibodies to type-specific capsular polysaccharides (CPSs) of GBS in the serum of animals used in experiments and of human neonates correlate with protection from GBS disease [8,9].…”

Multicenter Study of a Rapid Molecular-Based Assay for the Diagnosis of Group B Streptococcus Colonization in Pregnant Women

“…Group B Streptococcus (GBS) is the leading cause of infectious morbidity and mortality among newborns in North America [1][2][3][4][5]. The prevalence of GBS colonization in pregnant women varies from 15%-40% [6][7][8], with an incidence of 0.6 cases of early-onset neonatal disease per 1000 live births in the United States in 2000 [1].…”

The colonization incidence of group B streptococcus in pregnant women and their newborns in Istanbul

“…3,4 Before the preventive therapy, Canadian rates of GBS infection ranged from 0.44 to 2.1 per 1000 live births. 5 After the implementation of guidelines developed in 1996 by the Centers for Disease Control and prevention, The American College of Obstetrician and Gynecologist, and the American Academy of Pediatrics, maternal antibiotic therapy was used regularly during the past 5 years; 6 the mortality rate declined to 0.24 per 1000 live births in the Canadian study. 7 In order to decide the use of antibiotic therapy for maternal prophylaxis during pregnancy, we had to know the colonization rate for our country.…”