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Group B streptococcal carriage and disease: a 6-year prospective study
The Journal of Pediatrics
|January 1, 1987
Summary
Group B Streptococcus (GBS) carriage in mothers and infants is common. GBS disease in newborns, particularly early-onset, is linked to heavy colonization and intrauterine infection, highlighting maternal GBS as a key source.
Area of Science:
- Neonatal infections
- Bacterial pathogenesis
- Maternal-fetal medicine
Background:
- Group B Streptococcus (GBS) is a leading cause of neonatal infections.
- Understanding GBS carriage and disease transmission is crucial for prevention strategies.
Purpose of the Study:
- To prospectively evaluate GBS carriage rates in mothers and infants.
- To determine the incidence and characteristics of GBS disease in neonates.
- To identify risk factors associated with early- and late-onset GBS disease.
Main Methods:
- Prospective 6-year study of GBS carriage and disease in infants.
- Monitoring carriage rates in mothers and neonates at delivery.
- Tracking incidence of early- and late-onset GBS disease and associated risk factors.
Main Results:
- Maternal and infant GBS carriage rates were 20% and 12%, respectively.
- 45 cases of GBS disease occurred in infants (24 early-onset, 21 late-onset) with a combined attack rate of 3.3 per 1000 live births.
- High-risk factors for early-onset GBS included heavy neonatal colonization, intrauterine infection, preterm delivery, prolonged labor, and premature rupture of membranes.
- Late-onset GBS was predominantly septicemia, with GBS type III being most common, and often linked to maternal colonization.
Conclusions:
- Consistent year-to-year GBS carriage and disease rates were observed.
- Maternal GBS colonization is a significant source of neonatal infection, identified in 34 of 45 cases.
- Risk factors for early-onset GBS disease are multifactorial, emphasizing the importance of intrapartum events and maternal colonization.