Group B streptococcus; Streptococcus agalactiae; Neonatal infection; Early-onset disease; Late-onset disease; Group B streptococcal vaccine
Abstract :
[en] PURPOSE
Group B streptococcus (GBS) remains a leading cause of invasive disease, mainly sepsis and meningitis, in infants < 3 months of age and of mortality among neonates. This study, a major component of the European DEVANI project (Design of a Vaccine Against Neonatal Infections) describes clinical and important microbiological characteristics of neonatal GBS diseases. It quantifies the rate of antenatal screening and intrapartum antibiotic prophylaxis among cases and identifies risk factors associated with an adverse outcome.
METHODS
Clinical and microbiological data from 153 invasive neonatal cases (82 early-onset [EOD], 71 late-onset disease [LOD] cases) were collected in eight European countries from mid-2008 to end-2010.
RESULTS
Respiratory distress was the most frequent clinical sign at onset of EOD, while meningitis is found in > 30% of LOD. The study revealed that 59% of mothers of EOD cases had not received antenatal screening, whilst GBS was detected in 48.5% of screened cases. Meningitis was associated with an adverse outcome in LOD cases, while prematurity and the presence of cardiocirculatory symptoms were associated with an adverse outcome in EOD cases. Capsular-polysaccharide type III was the most frequent in both EOD and LOD cases with regional differences in the clonal complex distribution.
CONCLUSIONS
Standardizing recommendations related to neonatal GBS disease and increasing compliance might improve clinical care and the prevention of GBS EOD. But even full adherence to antenatal screening would miss a relevant number of EOD cases, thus, the most promising prophylactic approach against GBS EOD and LOD would be a vaccine for maternal immunization.
Research center :
CIRM - Centre Interdisciplinaire de Recherche sur le Médicament - ULiège GSK (formal Novartis) vaccine research, Siena, Italy National Reference Center Streptococcus agalactiae of Belgium - CHULiege
Disciplines :
Microbiology Pediatrics Immunology & infectious disease Reproductive medicine (gynecology, andrology, obstetrics) Laboratory medicine & medical technology Public health, health care sciences & services
Author, co-author :
Lohrmann, Florens; University of Freiburg, Germany
Hufnagel Markus; University of Freiburg, Germany
Kunze, Mirjam; University of Freiburg, Germany
Afshar Baharak; UK Health Security Agency GB, London UK
Creti, Roberta; Istituto Superiore Di Sanita, Roma, Italy
Detcheva, Antoaneta; National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria
Kosakova, Jana; National Institute of Public Health, Prague, Czech Republik
Rodriguez-Granger, Javier; Hospital Universitario Virgen de Las Nieves, Granada, Spain
Skov Sorensen, Uffe B.; AU - Aarhus University [DK]
Margarit, Immaculada; GSK Vaccines, Siena, Italy
Maione, Domenico; GSK Vaccines, Siena, Italy
Rinaudo, Daniela; GSK Vaccines, Siena, Italy
Orefici, Graziella; Istituto Superiore Di Sanita, Roma, Italy
Telford, John; GSK Vaccines, Siena, Italy
de la Rosa Fraile, Manuel; Hospital Universitario Virgen de Las Nieves, Granada, Spain
Kilian, Mogens; AU - Aarhus Universitet [DK]
Efstratiou, Androulla; UK Health Security Agency GB, London UK
Berner, Reinhard ✱; University Hospital Carl Gustav Carus, Dresden, Germany
Melin, Pierrette ✱; Université de Liège - ULiège > Département des sciences biomédicales et précliniques ; Centre Hospitalier Universitaire de Liège - CHU > > Service de microbiologie clinique ; The DEVANI Study Group
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