Epidemiology of Invasive Early-Onset and Late-Onset Group B Streptococcal Disease in the United States, 2006 to 2015: Multistate Laboratory and Population-Based Surveillance.
Srinivas Nanduri,Susan Petit,Chad Smelser,Mirasol Apostol,Nisha B Alden,Lee H. Harrison,Ruth Lynfield,Paula Snippes Vagnone,Kari Burzlaff,Nancy L Spina,Elizabeth Dufort,William Schaffner,Ann Thomas,Monica M. Farley,Monica M. Farley,Jennifer H. Jain,Tracy Pondo,Lesley McGee,Bernard Beall,Stephanie J. Schrag +19 more
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TLDR
Combined with addressing IAP implementation gaps, an effective vaccine covering the most common serotypes might further reduce EOD rates and help prevent LOD, for which there is no current public health intervention.Abstract:
Importance Invasive disease owing to group BStreptococcus(GBS) remains an important cause of illness and death among infants younger than 90 days in the United States, despite declines in early-onset disease (EOD; with onset at 0-6 days of life) that are attributed to intrapartum antibiotic prophylaxis (IAP). Maternal vaccines to prevent infant GBS disease are currently under development. Objective To describe incidence rates, case characteristics, antimicrobial resistance, and serotype distribution of EOD and late-onset disease (LOD; with onset at 7-89 days of life) in the United States from 2006 to 2015 to inform IAP guidelines and vaccine development. Design, Setting, and Participants This study used active population-based and laboratory-based surveillance for invasive GBS disease conducted through Active Bacterial Core surveillance in selected counties of 10 states across the United States. Residents of Active Bacterial Core surveillance areas who were younger than 90 days and had invasive GBS disease in 2006 to 2015 were included. Data were analyzed from December 2017 to April 2018. Exposures Group BStreptococcusisolated from a normally sterile site. Main Outcomes and Measures Early-onset disease and LOD incidence rates and associated GBS serotypes and antimicrobial resistance. Results The Active Bacterial Core surveillance program identified 1277 cases of EOD and 1387 cases of LOD. From 2006 to 2015, EOD incidence declined significantly from 0.37 to 0.23 per 1000 live births (P Conclusions and Relevance The rates of LOD among US infants are now higher than EOD rates. Combined with addressing IAP implementation gaps, an effective vaccine covering the most common serotypes might further reduce EOD rates and help prevent LOD, for which there is no current public health intervention.read more
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Early-Onset Neonatal Sepsis 2015 to 2017, the Rise of Escherichia coli, and the Need for Novel Prevention Strategies.
Barbara J. Stoll,Karen M. Puopolo,Nellie I. Hansen,Pablo J. Sánchez,Edward F. Bell,Waldemar A. Carlo,C. Michael Cotten,Carl T. D'Angio,S. Nadya J. Kazzi,Brenda B. Poindexter,Brenda B. Poindexter,Krisa P. Van Meurs,Ellen C. Hale,Monica V. Collins,Abhik Das,Carol J. Baker,Myra H. Wyckoff,Bradley A. Yoder,Kristi L. Watterberg,Michele C. Walsh,Uday Devaskar,Abbot R. Laptook,Gregory M Sokol,Stephanie J. Schrag,Rosemary D. Higgins,Rosemary D. Higgins +25 more
TL;DR: The rate of E coli infection increased among very low-birth-weight infants and associated mortality disproportionately occurred in preterm infants, and ongoing surveillance should monitor antibiotic susceptibilities of EOS pathogens.
Journal ArticleDOI
Management of Infants at Risk for Group B Streptococcal Disease
TL;DR: The American Academy of Pediatrics joins with the American College of Obstetricians and Gynecologists to reaffirm the use of universal antenatal microbiologic-based testing for the detection of maternal GBS colonization to facilitate appropriate administration of intrapartum antibiotic prophylaxis.
Journal ArticleDOI
The Double Life of Group B Streptococcus: Asymptomatic Colonizer and Potent Pathogen.
Blair Armistead,Elizabeth Oler,Kristina M. Adams Waldorf,Lakshmi Rajagopal,Lakshmi Rajagopal +4 more
TL;DR: This review summarizes the GBS and host factors involved in GBS's state as both an asymptomatic colonizer and an invasive pathogen and identifies novel strategies to mitigate GBS virulence.
Journal ArticleDOI
A review of antibiotic resistance in Group B Streptococcus: the story so far.
TL;DR: A comprehensive analysis of the prevalence of antibiotic resistance in Group B Streptococcus is provided and the specific resistance mechanisms identified in GBS isolates to date are outlined.
Journal ArticleDOI
Multistate, Population-Based Distributions of Candidate Vaccine Targets, Clonal Complexes, and Resistance Features of Invasive Group B Streptococci Within the United States, 2015-2017.
Lesley McGee,Sopio Chochua,Zhongya Li,Saundra Mathis,Joy Rivers,Benjamin J. Metcalf,Alison Ryan,Nisha B Alden,Monica M. Farley,Monica M. Farley,Lee H. Harrison,Paula Snippes Vagnone,Ruth Lynfield,Chad Smelser,Alison Muse,Ann Thomas,Stephanie J. Schrag,Bernard Beall +17 more
TL;DR: This first comprehensive, population-based quantitation of strain features in the United States suggests current vaccine candidates should have good coverage in Group B Streptococcus, and emergence of nonsusceptibility warrants ongoing monitoring.
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TL;DR: In this article, an analysis of active, population-based surveillance in 10 states participating in the Active Bacterial Core surveillance/Emerging Infections Program Network was performed to describe disease trends among populations that might benefit from vaccination and among newborns during a period of evolving prevention strategies.
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