Author
Joseph Bareta
Bio: Joseph Bareta is an academic researcher from New Mexico Department of Health. The author has contributed to research in topics: Population & Retrospective cohort study. The author has an hindex of 5, co-authored 8 publications receiving 542 citations.
Papers
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TL;DR: Improved management of preterm deliveries and improved collection, processing, and reporting of culture results may prevent additional cases of early-onset group B streptococcal disease.
Abstract: Background Group B streptococcal disease is one of the most common infections in the first week after birth. In 2002, national guidelines recommended universal late antenatal screening of pregnant women for colonization with group B streptococcus to identify candidates for intrapartum chemoprophylaxis. Methods We evaluated the implementation of the guidelines in a multistate, retrospective cohort selected from the Active Bacterial Core surveillance, a 10-state, population-based system that monitors invasive group B streptococcal disease. We abstracted data from the labor and delivery records of a stratified random sample of live births and of all cases in which the newborn had early-onset group B streptococcal disease (i.e., disease in infants <7 days of age) in 2003 and 2004. We compared our results with those from a study with a similar design that evaluated screening practices in 1998 and 1999. Results We abstracted records of 254 births in which the infant had group B streptococcal disease and 7437 bi...
341 citations
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TL;DR: WGS-based antimicrobial phenotype prediction was an informative alternative to BDT for invasive pneumococci and correctly predicted penicillin-binding protein types and common resistance determinants.
111 citations
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TL;DR: The WGS-based assignment of iGBS resistance features and serotypes is an accurate substitute for phenotypic testing.
100 citations
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Emory University1, Indiana University2, National Center for Immunization and Respiratory Diseases3, New Mexico Department of Health4, New York State Department of Health5, Colorado Department of Public Health and Environment6, Johns Hopkins University7, University of California, Berkeley8, Vanderbilt University9, Oregon Department of Human Services10
TL;DR: Prematurity in infants, advanced age and certain chronic diseases in adults were associated with an increased risk of in-hospital death, and nontypeable HI was associated with higher mortality in the elderly.
46 citations
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TL;DR: In 2002, updated national guidelines recommended universal culture-based antenatal screening of pregnant women during labor and delivery for detection of colonization with group B streptococcus, and four years later, a population-based surveillance study reported a 27% decrease in incidence of infections.
Abstract: In 2002, updated national guidelines recommended universal culture-based antenatal screening of pregnant women during labor and delivery for detection of colonization with group B streptococcus. Four years later, a population-based surveillance study reported a 27% decrease in incidence of e
26 citations
Cited by
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Emory University1, University of Texas Southwestern Medical Center2, University of Utah3, Indiana University4, Stanford University5, Yale University6, Duke University7, Tufts University8, Wayne State University9, University of Texas Health Science Center at Houston10, University of Alabama at Birmingham11, University of New Mexico12, University of Iowa13, Case Western Reserve University14, University of Cincinnati15, Brown University16, Centers for Disease Control and Prevention17, National Institutes of Health18
TL;DR: In the era of intrapartum chemoprophylaxis to reduce GBS, rates of EO infection have declined but reflect a continued burden of disease, suggesting that Escherichia coli is an important EO pathogen.
Abstract: BACKGROUND: Guidelines for prevention of group B streptococcal (GBS) infection have successfully reduced early onset (EO) GBS disease. Study results suggest that Escherichia coli is an important EO pathogen. OBJECTIVE: To determine EO infection rates, pathogens, morbidity, and mortality in a national network of neonatal centers. METHODS: Infants with EO infection were identified by prospective surveillance at Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Network centers. Infection was defined by positive culture results for blood and cerebrospinal fluid obtained from infants aged ≤72 hours plus treatment with antibiotic therapy for ≥5 days. Mother and infant characteristics, treatments, and outcomes were studied. Numbers of cases and total live births (LBs) were used to calculate incidence. RESULTS: Among 396 586 LBs (2006–2009), 389 infants developed EO infection (0.98 cases per 1000 LBs). Infection rates increased with decreasing birth weight. GBS (43%, 0.41 per 1000 LBs) and E coli (29%, 0.28 per 1000 LBs) were most frequently isolated. Most infants with GBS were term (73%); 81% with E coli were preterm. Mothers of 67% of infected term and 58% of infected preterm infants were screened for GBS, and results were positive for 25% of those mothers. Only 76% of mothers with GBS colonization received intrapartum chemoprophylaxis. Although 77% of infected infants required intensive care, 20% of term infants were treated in the normal newborn nursery. Sixteen percent of infected infants died, most commonly with E coli infection (33%). CONCLUSION: In the era of intrapartum chemoprophylaxis to reduce GBS, rates of EO infection have declined but reflect a continued burden of disease. GBS remains the most frequent pathogen in term infants, and E coli the most significant pathogen in preterm infants. Missed opportunities for GBS prevention continue. Prevention of E coli sepsis, especially among preterm infants, remains a challenge.
903 citations
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TL;DR: Early-onset sepsis remains a common and serious problem for neonates, especially preterm infants, and efforts toward maternal intrapartum antimicrobial prophylaxis have significantly reduced the rates of GBS disease but have been associated with increased rates of Gram-negative infections.
Abstract: Early-onset sepsis remains a common and serious problem for neonates, especially preterm infants. Group B streptococcus (GBS) is the most common etiologic agent, while Escherichia coli is the most common cause of mortality. Current efforts toward maternal intrapartum antimicrobial prophylaxis have significantly reduced the rates of GBS disease but have been associated with increased rates of Gram-negative infections, especially among very-low-birth-weight infants. The diagnosis of neonatal sepsis is based on a combination of clinical presentation; the use of nonspecific markers, including C-reactive protein and procalcitonin (where available); blood cultures; and the use of molecular methods, including PCR. Cytokines, including interleukin 6 (IL-6), interleukin 8 (IL-8), gamma interferon (IFN-γ), and tumor necrosis factor alpha (TNF-α), and cell surface antigens, including soluble intercellular adhesion molecule (sICAM) and CD64, are also being increasingly examined for use as nonspecific screening measures for neonatal sepsis. Viruses, in particular enteroviruses, parechoviruses, and herpes simplex virus (HSV), should be considered in the differential diagnosis. Empirical treatment should be based on local patterns of antimicrobial resistance but typically consists of the use of ampicillin and gentamicin, or ampicillin and cefotaxime if meningitis is suspected, until the etiologic agent has been identified. Current research is focused primarily on development of vaccines against GBS.
761 citations
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TL;DR: The current global burden of invasive disease and the serotype distribution of group B streptococcus isolates is examined and a conjugate vaccine incorporating five serotypes could prevent most global group B Streptococcal disease.
529 citations
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01 Jan 2007TL;DR: The 2002 Prevention of Perinatal Group B Streptococcal Disease guidelines from the Center for Disease Control represents a revision of a prior set of guidelines represented by the CDC in 1996, and included a recommendation for universal prenatal screening for GBS.
Abstract: The 2002 Prevention of Perinatal Group B Streptococcal Disease guidelines from the Center for Disease Control (CDC) represents a revision of a prior set of guidelines represented by the CDC in 1996. Group B streptococcus (GBS) remains a leading cause of serious neonatal infection despite the significant efforts in the disease prevention through the 1990s, including recommendations presented by the CDC, the American College of Obstetricians and Gynecologists (ACOG), and by the American Academy of Pediatrics (AAP). The updated 2002 guidelines were based on clinical evidence and expert opinions gathered since the 1996 recommendations (1). Significant changes in the newer guidelines included a recommendation for universal prenatal screening for GBS; detailed instructions on specimen collection, processing and testing; updated prophylaxis regimens for penicillin-allergic women; recommendations against routine antipartum antibiotic prophylaxis for GBS-colonized women undergoing planned cesarean deliveries prior to the onset of labor or the rupture of membranes; a suggested algorithm for management of threatened preterm delivery; and an updated algorithm for the management of newborns exposed to intrapartum antibiotics.
469 citations
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TL;DR: The burden of invasive EOS remains substantial in the era of GBS prevention and disproportionately affects preterm and black infants and Identification of strategies to prevent preterm births is needed to reduce the neonatal sepsis burden.
Abstract: Background
Sepsis in the first 3 days of life is a leading cause of morbidity and mortality among infants. Group B Streptococcus (GBS), historically the primary cause of early-onset sepsis, has declined through widespread use of intrapartum chemoprophylaxis. We estimated the national burden of invasive early-onset sepsis (EOS) cases and deaths in the era of GBS prevention.
415 citations