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2017 ; 65
(suppl_2
): S100-S111
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Maternal Colonization With Group B Streptococcus and Serotype Distribution
Worldwide: Systematic Review and Meta-analyses
#MMPMID29117327
Russell NJ
; Seale AC
; O'Driscoll M
; O'Sullivan C
; Bianchi-Jassir F
; Gonzalez-Guarin J
; Lawn JE
; Baker CJ
; Bartlett L
; Cutland C
; Gravett MG
; Heath PT
; Le Doare K
; Madhi SA
; Rubens CE
; Schrag S
; Sobanjo-Ter Meulen A
; Vekemans J
; Saha SK
; Ip M
Clin Infect Dis
2017[Nov]; 65
(suppl_2
): S100-S111
PMID29117327
show ga
BACKGROUND: Maternal rectovaginal colonization with group B Streptococcus (GBS)
is the most common pathway for GBS disease in mother, fetus, and newborn. This
article, the second in a series estimating the burden of GBS, aims to determine
the prevalence and serotype distribution of GBS colonizing pregnant women
worldwide. METHODS: We conducted systematic literature reviews (PubMed/Medline,
Embase, Latin American and Caribbean Health Sciences Literature [LILACS], World
Health Organization Library Information System [WHOLIS], and Scopus), organized
Chinese language searches, and sought unpublished data from investigator groups.
We applied broad inclusion criteria to maximize data inputs, particularly from
low- and middle-income contexts, and then applied new meta-analyses to adjust for
studies with less-sensitive sampling and laboratory techniques. We undertook
meta-analyses to derive pooled estimates of maternal GBS colonization prevalence
at national and regional levels. RESULTS: The dataset regarding colonization
included 390 articles, 85 countries, and a total of 299924 pregnant women. Our
adjusted estimate for maternal GBS colonization worldwide was 18% (95% confidence
interval [CI], 17%-19%), with regional variation (11%-35%), and lower prevalence
in Southern Asia (12.5% [95% CI, 10%-15%]) and Eastern Asia (11% [95% CI,
10%-12%]). Bacterial serotypes I-V account for 98% of identified colonizing GBS
isolates worldwide. Serotype III, associated with invasive disease, accounts for
25% (95% CI, 23%-28%), but is less frequent in some South American and Asian
countries. Serotypes VI-IX are more common in Asia. CONCLUSIONS: GBS colonizes
pregnant women worldwide, but prevalence and serotype distribution vary, even
after adjusting for laboratory methods. Lower GBS maternal colonization
prevalence, with less serotype III, may help to explain lower GBS disease
incidence in regions such as Asia. High prevalence worldwide, and more serotype
data, are relevant to prevention efforts.