Evolution of the incidence of early-onset and late-onset group B Streptococcal disease before and after prevention policies Barcelona 19942007
Abstract number: P2226
Andreu A., Juncosa T., Bosch J., Sierra M., Gimenez M., Sanfeliu I., Lite J., Dopico E., Guardia C., Viñas L., Sanchez F.
Objective: Between 1994 and 1999 the prophylactic strategy based in universal prenatal group B Streptococcal (GBS) screening and intrapartum antibiotic for GBS-colonized women, and for women with unknown status and delivery <37 weeks, amniotic membrane rupture or intrapartum fewer, was progressively implemented in 10 Barcelona-area hospitals. The aim of the study is to continue monitoring trends of early-onset GBS disease in these 10 hospitals, and to assess if the observed decreases in its incidence has been accompanied by increases in the incidence of late-onset GBS disease.
Results: From 1994 to 2006, 282.046 live infants were born in our hospitals. Early-onset GBS disease, defined as the presence of GBS in a sterile fluid (blood, CSF, etc) within the first week of life, was diagnosed in 219 neonates. During the 12 years of the study the incidence decreased as follows: 2.25 per 1000 in 1994, 1.88 in 1995, 1.53 in 1996, 1.23 in 1997, 0.66 in 1998, 0.48 in 1999, 0.56 in 2000, 0.39 in 2001, 0.47 in 2002, 0.41 in 2003, 0.24 in 2004, 0.58 in 2005 and 0.23 in 2006 These rates indicated that over this period of time the incidence decreased by 83% (RR 0.830; 95% CI 0.7990.863, P < 0.001). In the year 2006, incidences in individual hospitals ranged from 0.54 to 0 per 1000.
From 1996 to 2006, 245.672 live infants were born in our hospitals. Late-onset GBS disease, defined as the presence of GBS in a sterile fluid (blood, CSF, etc) in infants aged between 8 and 90 days of life, was diagnosed in 90 cases. During the 10 years of the study the incidence fluctuated as follows: 0.11 per 1000 in 1996, 0.51 in 1997, 0.36 in 1998, 0.39 in 1999, 0.14 in 2000, 0.22 in 2001, 0.35 in 2002, 0.25 in 2003, 0.60 in 2004, 0.58 in 2005 and 0.42 in 2006 (RR 1.068; 95% CI 0.9981.143, P =0.057). Although not significant, these rates of incidence suggested a slightly tendency to increase annually by 6.5%.
Conclusions: The application of prevention measures supposed a substantial decrease in the incidence of early-onset GBS disease during the firsts years and a maintained low rates till now. In contrast, the incidence of late-onset GBS disease fluctuated over the years, and although not significant, there it seems to be a slightly tendency to increase, suggesting that intrapartum antibiotics is not effective against late-onset GBS disease. Continue surveillance of late-onset GBS disease is needed to monitor the impact of the recommended prophylactic strategy.
|Session name:||18th European Congress of Clinical Microbiology and Infectious Diseases|
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