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A Murine Model of Group B Streptococcus Vaginal Colonization
Published on: November 16, 2016
Infant Group B Streptococcal Disease Incidence and Serotypes Worldwide: Systematic Review and Meta-analyses
Lola Madrid1,2,3, Anna C Seale2,4, Maya Kohli-Lynch2,5
1ISGlobal, Barcelona Centre for International Health Research, Hospital Clinic-University of Barcelona, Spain.
Insights
Group B Streptococcus (GBS) infant invasive disease incidence is 0.49 per 1000 live births globally, highest in Africa. Serotype III is most common, highlighting regional disparities in GBS burden.
Area of Science:
- Global health
- Infectious diseases
- Neonatal health
Background:
- Group B Streptococcus (GBS) is a major cause of neonatal sepsis, despite antibiotic prophylaxis efforts.
- Incidence appears higher in Africa, where intrapartum antibiotic prophylaxis (IAP) is less common.
- Previous global estimates of GBS disease incidence in infants needed updating.
Purpose of the Study:
- To investigate the global incidence of invasive GBS disease in infants (0-89 days).
- To identify the predominant GBS serotypes causing invasive disease worldwide.
- To provide updated estimates of GBS disease burden and case fatality risk.
Main Methods:
- Conducted systematic literature reviews across multiple databases (PubMed, Embase, LILACS, WHOLIS, Scopus).
- Included unpublished data on invasive GBS disease in infants aged 0-89 days.
- Performed random-effects meta-analyses to pool incidence, case fatality risk (CFR), and serotype prevalence.
Main Results:
- Pooled incidence of invasive GBS disease was 0.49 per 1000 live births, with highest rates in Africa (1.12) and lowest in Asia (0.30).
- Early-onset disease incidence was 0.41 and late-onset disease incidence was 0.26 per 1000 live births.
- Case fatality risk (CFR) was 8.4%, and Serotype III accounted for 61.5% of cases, with Ia, Ib, II, III, and V causing 97% of infections.
Conclusions:
- Infant GBS disease incidence remains high in certain regions, notably Africa.
- Underestimation of incidence is possible due to limitations in data collection and ascertainment.
- Further investigation into the GBS disease burden in Asia is warranted.
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.
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