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2017 ; 65
(suppl_2
): S160-S172
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Infant Group B Streptococcal Disease Incidence and Serotypes Worldwide:
Systematic Review and Meta-analyses
#MMPMID29117326
Madrid L
; Seale AC
; Kohli-Lynch M
; Edmond KM
; Lawn JE
; Heath PT
; Madhi SA
; Baker CJ
; Bartlett L
; Cutland C
; Gravett MG
; Ip M
; Le Doare K
; Rubens CE
; Saha SK
; Sobanjo-Ter Meulen A
; Vekemans J
; Schrag S
Clin Infect Dis
2017[Nov]; 65
(suppl_2
): S160-S172
PMID29117326
show ga
BACKGROUND: Group B Streptococcus (GBS) remains a leading cause of neonatal
sepsis in high-income contexts, despite declines due to intrapartum antibiotic
prophylaxis (IAP). Recent evidence suggests higher incidence in Africa, where IAP
is rare. We investigated the global incidence of infant invasive GBS disease and
the associated serotypes, updating previous estimates. 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Information System [WHOLIS], and Scopus) and sought unpublished data regarding
invasive GBS disease in infants aged 0-89 days. We conducted random-effects
meta-analyses of incidence, case fatality risk (CFR), and serotype prevalence.
RESULTS: We identified 135 studies with data on incidence (n = 90), CFR (n = 64),
or serotype (n = 45). The pooled incidence of invasive GBS disease in infants was
0.49 per 1000 live births (95% confidence interval [CI], .43-.56), and was
highest in Africa (1.12) and lowest in Asia (0.30). Early-onset disease incidence
was 0.41 (95% CI, .36-.47); late-onset disease incidence was 0.26 (95% CI,
.21-.30). CFR was 8.4% (95% CI, 6.6%-10.2%). Serotype III (61.5%) dominated, with
97% of cases caused by serotypes Ia, Ib, II, III, and V. CONCLUSIONS: The
incidence of infant GBS disease remains high in some regions, particularly
Africa. We likely underestimated incidence in some contexts, due to limitations
in case ascertainment and specimen collection and processing. Burden in Asia
requires further investigation.
|*Streptococcus agalactiae/classification
[MESH]
|Global Health/statistics & numerical data
[MESH]
|Humans
[MESH]
|Incidence
[MESH]
|Infant, Newborn
[MESH]
|Infant, Newborn, Diseases/epidemiology/etiology/*microbiology/prevention &
control
[MESH]