Early-onset neonatal infections in Australia and New Zealand, 2002–2012

2018 ◽  
Vol 104 (3) ◽  
pp. F248-F252 ◽  
Author(s):  
Tarun Singh ◽  
Elizabeth H Barnes ◽  
David Isaacs
Keyword(s):  
New Zealand ◽  
Incidence Rate ◽  
Early Onset ◽  
Group B Streptococcus ◽  
E Coli ◽  
Live Births ◽  
Early Onset Sepsis ◽  
Group B ◽  
Almost All ◽  
Over Time

BackgroundThe epidemiology of early-onset neonatal sepsis (EONS) varies over time, and requires regular surveillance.ObjectiveTo analyse data on EONS in Australia and New Zealand.MethodsRetrospective analysis of data collected longitudinally from multiple neonatal units from 2002 to 2012.ResultsOf 386 423 live births, 454 infants had EONS. The incidence rate of EONS was 1.20 per 1000 live births in 2002 and 0.83 in 2012, decreasing by 4% per year (95% CI 1% to 7%, p=0.007). Group B streptococcus (GBS) (37%) and Escherichia coli (25%) were the most prevalent organisms. The early-onset GBS (EOGBS) incidence rate was 0.43/1000 live births, with no evidence of change over time (p=0.3). Of EOGBS-infected babies, 62% were born at term compared with 8% with early-onset E. coli sepsis, p<0.0001. The mortality of E. coli early-onset sepsis (EOS) (25%) was higher than GBS (11%), but this difference in mortality was no longer significant after adjusting for gestation and birth weight. Mortality from EOS fell significantly over the study period (17% per year, 95% CI 10 to 24, p<0.0001).ConclusionsGBS was the most common cause of early sepsis, but the incidence was lower than prior to the introduction of intrapartum antibiotic prophylaxis, and remained steady over time. The mortality of early-onset E. coli sepsis was significantly higher than GBS sepsis, but this may have been because almost all babies with E. coli were born preterm, rather than a difference in virulence.

scholarly journals To screen or not to screen women for Group B Streptococcus (Streptococcus agalactiae) to prevent early onset sepsis in newborns: recent advances in the unresolved debate

2020 ◽  
Vol 7 ◽  
pp. 204993612094242
Author(s):  
Guduru Gopal Rao ◽  
Priya Khanna
Keyword(s):  
Risk Factor ◽  
Antimicrobial Resistance ◽  
Low Income ◽  
Streptococcus Agalactiae ◽  
Early Onset ◽  
Group B Streptococcus ◽  
Developed Countries ◽  
Low Income Countries ◽  
Early Onset Sepsis ◽  
Group B

Streptococcus agalactiae, also known as Group B streptococcus (GBS) is the commonest cause of early onset sepsis in newborns in developed high-income countries. Intrapartum antimicrobial (antibiotic) prophylaxis (IAP) is recognized to be highly effective in preventing early onset Group B sepsis (EOGBS) in newborns. The key controversy is about the strategy that should be used to identify mothers who should receive IAP. There are two strategies that are followed in developed countries: screening-based or risk-factor-based identification of women requiring IAP. The debate regarding which of the two approaches is better has intensified in the recent years with concerns about antimicrobial resistance, effect on newborn’s microbiome and other adverse effects. In this review, we have discussed some of the key research papers published in the period 2015–2019 that have addressed the relative merits and disadvantages of screening versus risk-factor-based identification of women requiring IAP. Although screening-based IAP appears to be more efficacious than risk-based IAP, IAP-based prevention has several limitations including ineffectiveness in prevention of late-onset GBS infection in babies, premature and still births, impact of IAP on neonatal microbiota, emergence of antimicrobial resistance and difficulties in implementing IAP-based strategies in middle and low income countries. Alternative strategies, principally maternal immunization against GBS would circumvent use of IAP. However, no licensed vaccines are currently available for use.

The Use of Blood Counts and Blood Cultures to Screen Neonates Born to Partially Treated Group B Streptococcus-carrier Mothers for Early-onset Sepsis

2011 ◽  
Vol 30 (10) ◽  
pp. 840-843 ◽  
Author(s):  
Saar Hashavya ◽  
Shmuel Benenson ◽  
Zivanit Ergaz-Shaltiel ◽  
Benjamin Bar-Oz ◽  
Diana Averbuch ◽  
...  
Keyword(s):  
Early Onset ◽  
Group B Streptococcus ◽  
Treated Group ◽  
Blood Cultures ◽  
Early Onset Sepsis ◽  
Group B

scholarly journals Early-onset neonatal sepsis: Organism patterns between 2009 and 2014

2019 ◽  
Vol 25 (7) ◽  
pp. 425-431
Author(s):  
Michael Sgro ◽  
Douglas M Campbell ◽  
Kaitlyn L Mellor ◽  
Kathleen Hollamby ◽  
Jaya Bodani ◽  
...  
Keyword(s):  
Neonatal Sepsis ◽  
Early Onset ◽  
Neonatal Intensive Care ◽  
Group B Streptococcus ◽  
Neonatal Intensive Care Units ◽  
Causative Organism ◽  
Term Infants ◽  
E Coli ◽  
Group B ◽  
Reported Data

Abstract Objective To evaluate trends in organisms causing early-onset neonatal sepsis (EONS). Congruent with recent reports, we hypothesized there would be an increase in EONS caused by Escherichia coli. Study Design National data on infants admitted to neonatal intensive care units from 2009 to 2014 were compared to previously reported data from 2003 to 2008. We report 430 cases of EONS from 2009 to 2014. Bivariate analyses were used to analyze the distribution of causative organisms over time and differences by gestational age. Linear regression was used to estimate trends in causative organisms. Results Since 2003, there has been a trend of increasing numbers of cases caused by E coli (P&lt;0.01). The predominant organism was E coli in preterm infants and Group B Streptococcus in term infants. Conclusions With the majority of EONS cases now caused by E coli, our findings emphasize the importance of continued surveillance of causative organism patterns and developing approaches to reduce cases caused by E coli.

scholarly journals Group B streptococcal neonatal infections in Rio Grande do Sul, Brazil

2001 ◽  
Vol 43 (5) ◽  
pp. 243-246 ◽  
Author(s):  
Ernani MIURA ◽  
Maria Cristina MARTIN
Keyword(s):  
Blood Culture ◽  
Neonatal Sepsis ◽  
Early Onset ◽  
Late Onset ◽  
Group B Streptococcus ◽  
Neurological Deficits ◽  
Neonatal Infections ◽  
Laboratory Findings ◽  
Early Onset Sepsis ◽  
Group B

Group B Streptococcus is the most common pathogen found in neonatal sepsis in North America. OBJECTIVES: We describe 15 cases of neonatal infections by Group B Streptococcus (Streptococcus agalactiae) at a Neonatal Intensive Care Unit of a public and teaching hospital. METHODS: We conducted a study at Hospital de Clínicas de Porto Alegre, from January 1st, 1996 to June 30, 1999. Diagnosis of neonatal infection was established according to the findings of Group B Streptococcus in blood culture associated with alterations resembling sepsis on the basis of clinical picture and laboratory findings. RESULTS: Fifteen cases of neonatal infections by Group B Streptococcus were detected. Eleven cases consisted of early-onset sepsis, 2 cases of occult bacteremia and 2 cases of late-onset sepsis. Eight cases had septic shock (53%), 8 cases had pneumonia (53%), and 4 cases had meningitis (27%). Fourteen cases were diagnosed from a positive blood culture, and 1 case from evidence of these bacteria in pulmonary anatomopathological examination. Thirteen cases (87%) were diagnosed before 72 hours of life. We had 3 deaths (20%), and 3 cases of meningitis developing neurological deficits. CONCLUSIONS: Streptococcus Group B is one of the most important pathogens in the etiology of early-onset neonatal sepsis at our hospital, with high mortality and morbidity. However, we do not know the incidence of GBS neonatal infections at other hospitals. More data are needed to establish a basis for trials of different strategies to reduce these infections.

Neonatal implications of early-onset group B streptococcal disease

1998 ◽  
Vol 10 (4) ◽  
pp. 181-196
Author(s):  
Nicholas D Embleton
Keyword(s):  
Early Onset ◽  
Group B Streptococcus ◽  
Developed Countries ◽  
The United States ◽  
Epidemiological Studies ◽  
Clinical Aspects ◽  
Streptococcal Disease ◽  
Early Onset Sepsis ◽  
Group B Streptococcal Disease ◽  
Group B

Group B streptococcal disease is the commonest cause of early-onset neonatal sepsis in most developed countries. Recent epidemiological studies and controlled trials have shown that many cases are theoretically preventable and guidelines have been widely adopted in the United States and Australia but are not common place in much of Europe. Infections caused by group B streptococcus may present at any time before, during or after delivery. This article reviews aspects of early-onset sepsis in the newborn infant (clinical presentation in the first 48 hours) as almost all of these cases are maternally acquired. Microbiological, epidemiological, pathophysiological and clinical aspects of the disease are discussed, and the practical implications of adopting preventative programmes are addressed.

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