Group B streptococcal infection epidemiology and demographics: Difference between revisions
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==Overview== | ==Overview== | ||
Group B Streptococcus (GBS) causes invasive disease primarily in infants, pregnant or postpartum women, and older adults, with the highest incidence among young infants.<ref name="pmid18460666">{{cite journal| author=Phares CR, Lynfield R, Farley MM, Mohle-Boetani J, Harrison LH, Petit S et al.| title=Epidemiology of invasive group B streptococcal disease in the United States, 1999-2005. | journal=JAMA | year= 2008 | volume= 299 | issue= 17 | pages= 2056-65 | pmid=18460666 | doi=10.1001/jama.299.17.2056 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18460666 }} </ref> Before active prevention was initiated, an estimated 7,500 cases of neonatal GBS disease occurred annually in the United States.<ref name="pmid1470102">{{cite journal| author=Zangwill KM, Schuchat A, Wenger JD| title=Group B streptococcal disease in the United States, 1990: report from a multistate active surveillance system. | journal=MMWR CDC Surveill Summ | year= 1992 | volume= 41 | issue= 6 | pages= 25-32 | pmid=1470102 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1470102 }} </ref> Striking declines in disease incidence coincided with increased prevention activities in the 1990s,<ref name="pmid10620644">{{cite journal| author=Schrag SJ, Zywicki S, Farley MM, Reingold AL, Harrison LH, Lefkowitz LB et al.| title=Group B streptococcal disease in the era of intrapartum antibiotic prophylaxis. | journal=N Engl J Med | year= 2000 | volume= 342 | issue= 1 | pages= 15-20 | pmid=10620644 | doi=10.1056/NEJM200001063420103 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10620644 }} </ref> and a further reduction occurred following the issuance of the recommendation for universal screening in 2002.<ref name=CDC2007>CDC. Perinatal group B streptococcal disease after universal screening recommendations---United States, 2003--2005. MMWR 2007;56:701--5.[http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5628a1.htm]</ref> However, GBS disease remains the leading infectious cause of morbidity and mortality among newborns in the United States.<ref name="pmid18460666">{{cite journal| author=Phares CR, Lynfield R, Farley MM, Mohle-Boetani J, Harrison LH, Petit S et al.| title=Epidemiology of invasive group B streptococcal disease in the United States, 1999-2005. | journal=JAMA | year= 2008 | volume= 299 | issue= 17 | pages= 2056-65 | pmid=18460666 | doi=10.1001/jama.299.17.2056 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18460666 }} </ref><ref name=CDC2009>CDC. Trends in perinatal group B streptococcal disease---United States, 2000--2006. MMWR 2009;58:109--12.[http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5805a2.htm]</ref> The continued burden of disease and newly available data relevant to early-onset GBS disease prevention from the fields of epidemiology, obstetrics, neonatology, microbiology, molecular biology, and pharmacology prompted revision of the guidelines for early-onset GBS disease prevention.<ref name=CDCMMWR>Verani J.R., McGee L, and Schrag S.J. Prevention of Perinatal Group B Streptococcal Disease. Revised Guidelines from CDC, 2010.[http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5910a1.htm?s_cid=rr5910a1_w CDC.gov]</ref> | Group B Streptococcus (GBS) causes invasive disease primarily in infants, pregnant or postpartum women, and older adults, with the highest incidence among young infants.<ref name="pmid18460666">{{cite journal| author=Phares CR, Lynfield R, Farley MM, Mohle-Boetani J, Harrison LH, Petit S et al.| title=Epidemiology of invasive group B streptococcal disease in the United States, 1999-2005. | journal=JAMA | year= 2008 | volume= 299 | issue= 17 | pages= 2056-65 | pmid=18460666 | doi=10.1001/jama.299.17.2056 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18460666 }} </ref> Before active prevention was initiated, an estimated 7,500 cases of neonatal GBS disease occurred annually in the United States.<ref name="pmid1470102">{{cite journal| author=Zangwill KM, Schuchat A, Wenger JD| title=Group B streptococcal disease in the United States, 1990: report from a multistate active surveillance system. | journal=MMWR CDC Surveill Summ | year= 1992 | volume= 41 | issue= 6 | pages= 25-32 | pmid=1470102 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1470102 }} </ref> Striking declines in disease incidence coincided with increased prevention activities in the 1990s,<ref name="pmid10620644">{{cite journal| author=Schrag SJ, Zywicki S, Farley MM, Reingold AL, Harrison LH, Lefkowitz LB et al.| title=Group B streptococcal disease in the era of intrapartum antibiotic prophylaxis. | journal=N Engl J Med | year= 2000 | volume= 342 | issue= 1 | pages= 15-20 | pmid=10620644 | doi=10.1056/NEJM200001063420103 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10620644 }} </ref> and a further reduction occurred following the issuance of the recommendation for universal screening in 2002.<ref name=CDC2007>CDC. Perinatal group B streptococcal disease after universal screening recommendations---United States, 2003--2005. MMWR 2007;56:701--5.[http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5628a1.htm]</ref> However, GBS disease remains the leading infectious cause of morbidity and mortality among newborns in the United States.<ref name="pmid18460666">{{cite journal| author=Phares CR, Lynfield R, Farley MM, Mohle-Boetani J, Harrison LH, Petit S et al.| title=Epidemiology of invasive group B streptococcal disease in the United States, 1999-2005. | journal=JAMA | year= 2008 | volume= 299 | issue= 17 | pages= 2056-65 | pmid=18460666 | doi=10.1001/jama.299.17.2056 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18460666 }} </ref><ref name=CDC2009>CDC. Trends in perinatal group B streptococcal disease---United States, 2000--2006. MMWR 2009;58:109--12.[http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5805a2.htm]</ref> The continued burden of disease and newly available data relevant to early-onset GBS disease prevention from the fields of epidemiology, obstetrics, neonatology, microbiology, molecular biology, and pharmacology prompted revision of the guidelines for early-onset GBS disease prevention.<ref name=CDCMMWR>Verani J.R., McGee L, and Schrag S.J. Prevention of Perinatal Group B Streptococcal Disease. Revised Guidelines from CDC, 2010.[http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5910a1.htm?s_cid=rr5910a1_w CDC.gov]</ref> | ||
==Epidemiology and Demographics== | |||
===Early-Onset GBS Disease=== | |||
GBS is the leading infectious cause of [[morbidity]] and mortality among infants in the United States. As a result of prevention efforts, incidence of GBS has declined dramatically over the past 15 years, from 1.7 cases per 1,000 live births in the early 1990s to 0.34--0.37 cases per 1,000 live births in recent years. On the basis of data from CDC's Active Bacterial Core surveillance (ABCs) system, a network of 10 sites across the United States that conduct active, population-based surveillance, CDC estimates that in recent years, GBS has caused approximately 1,200 cases of early-onset invasive disease per year;<ref name=CDCsurveillance>CDC. Active Bacterial Core Surveillance Report, Emerging Infections Program Network, Group B Streptococcus, 2008. Atlanta, GA: US Department of Health and Human Services, CDC; 2009. Available at [http://www.cdc.gov/abcs/reports-findings/survreports/gbs08.html cdc.gov].</ref> approximately 70% of cases are among babies born at term (≥37 weeks' gestation)..<ref name="pmid18460666">{{cite journal| author=Phares CR, Lynfield R, Farley MM, Mohle-Boetani J, Harrison LH, Petit S et al.| title=Epidemiology of invasive group B streptococcal disease in the United States, 1999-2005. | journal=JAMA | year= 2008 | volume= 299 | issue= 17 | pages= 2056-65 | pmid=18460666 | doi=10.1001/jama.299.17.2056 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18460666 }} </ref> | |||
The case-fatality ratio of early-onset disease has declined from as high as 50% in the 1970s<ref name="pmid4608888">{{cite journal| author=Baker CJ, Barrett FF| title=Group B streptococcal infections in infants. The importance of the various serotypes. | journal=JAMA | year= 1974 | volume= 230 | issue= 8 | pages= 1158-60 | pmid=4608888 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=4608888 }} </ref> to 4%--6% in recent years, primarily because of advances in neonatal care.<ref name="pmid18460666">{{cite journal| author=Phares CR, Lynfield R, Farley MM, Mohle-Boetani J, Harrison LH, Petit S et al.| title=Epidemiology of invasive group B streptococcal disease in the United States, 1999-2005. | journal=JAMA | year= 2008 | volume= 299 | issue= 17 | pages= 2056-65 | pmid=18460666 | doi=10.1001/jama.299.17.2056 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18460666 }} </ref><ref name="pmid10620644">{{cite journal| author=Schrag SJ, Zywicki S, Farley MM, Reingold AL, Harrison LH, Lefkowitz LB et al.| title=Group B streptococcal disease in the era of intrapartum antibiotic prophylaxis. | journal=N Engl J Med | year= 2000 | volume= 342 | issue= 1 | pages= 15-20 | pmid=10620644 | doi=10.1056/NEJM200001063420103 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10620644 }} </ref> Mortality is higher among preterm infants, with case-fatality rates of approximately 20% and as high as 30% among those ≤33 weeks' gestation, compared with 2%--3% among full-term infants.<ref name="pmid18460666">{{cite journal| author=Phares CR, Lynfield R, Farley MM, Mohle-Boetani J, Harrison LH, Petit S et al.| title=Epidemiology of invasive group B streptococcal disease in the United States, 1999-2005. | journal=JAMA | year= 2008 | volume= 299 | issue= 17 | pages= 2056-65 | pmid=18460666 | doi=10.1001/jama.299.17.2056 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18460666 }} </ref><ref name="pmid10620644">{{cite journal| author=Schrag SJ, Zywicki S, Farley MM, Reingold AL, Harrison LH, Lefkowitz LB et al.| title=Group B streptococcal disease in the era of intrapartum antibiotic prophylaxis. | journal=N Engl J Med | year= 2000 | volume= 342 | issue= 1 | pages= 15-20 | pmid=10620644 | doi=10.1056/NEJM200001063420103 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10620644 }} </ref> | |||
==References== | ==References== | ||
Revision as of 18:48, 19 August 2014
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [3]; Associate Editor(s)-in-Chief: Rim Halaby, M.D. [4]
Overview
Group B Streptococcus (GBS) causes invasive disease primarily in infants, pregnant or postpartum women, and older adults, with the highest incidence among young infants.[1] Before active prevention was initiated, an estimated 7,500 cases of neonatal GBS disease occurred annually in the United States.[2] Striking declines in disease incidence coincided with increased prevention activities in the 1990s,[3] and a further reduction occurred following the issuance of the recommendation for universal screening in 2002.[4] However, GBS disease remains the leading infectious cause of morbidity and mortality among newborns in the United States.[1][5] The continued burden of disease and newly available data relevant to early-onset GBS disease prevention from the fields of epidemiology, obstetrics, neonatology, microbiology, molecular biology, and pharmacology prompted revision of the guidelines for early-onset GBS disease prevention.[6]
Epidemiology and Demographics
Early-Onset GBS Disease
GBS is the leading infectious cause of morbidity and mortality among infants in the United States. As a result of prevention efforts, incidence of GBS has declined dramatically over the past 15 years, from 1.7 cases per 1,000 live births in the early 1990s to 0.34--0.37 cases per 1,000 live births in recent years. On the basis of data from CDC's Active Bacterial Core surveillance (ABCs) system, a network of 10 sites across the United States that conduct active, population-based surveillance, CDC estimates that in recent years, GBS has caused approximately 1,200 cases of early-onset invasive disease per year;[7] approximately 70% of cases are among babies born at term (≥37 weeks' gestation)..[1]
The case-fatality ratio of early-onset disease has declined from as high as 50% in the 1970s[8] to 4%--6% in recent years, primarily because of advances in neonatal care.[1][3] Mortality is higher among preterm infants, with case-fatality rates of approximately 20% and as high as 30% among those ≤33 weeks' gestation, compared with 2%--3% among full-term infants.[1][3]
References
- ↑ 1.0 1.1 1.2 1.3 1.4 Phares CR, Lynfield R, Farley MM, Mohle-Boetani J, Harrison LH, Petit S; et al. (2008). "Epidemiology of invasive group B streptococcal disease in the United States, 1999-2005". JAMA. 299 (17): 2056–65. doi:10.1001/jama.299.17.2056. PMID 18460666.
- ↑ Zangwill KM, Schuchat A, Wenger JD (1992). "Group B streptococcal disease in the United States, 1990: report from a multistate active surveillance system". MMWR CDC Surveill Summ. 41 (6): 25–32. PMID 1470102.
- ↑ 3.0 3.1 3.2 Schrag SJ, Zywicki S, Farley MM, Reingold AL, Harrison LH, Lefkowitz LB; et al. (2000). "Group B streptococcal disease in the era of intrapartum antibiotic prophylaxis". N Engl J Med. 342 (1): 15–20. doi:10.1056/NEJM200001063420103. PMID 10620644.
- ↑ CDC. Perinatal group B streptococcal disease after universal screening recommendations---United States, 2003--2005. MMWR 2007;56:701--5.[1]
- ↑ CDC. Trends in perinatal group B streptococcal disease---United States, 2000--2006. MMWR 2009;58:109--12.[2]
- ↑ Verani J.R., McGee L, and Schrag S.J. Prevention of Perinatal Group B Streptococcal Disease. Revised Guidelines from CDC, 2010.CDC.gov
- ↑ CDC. Active Bacterial Core Surveillance Report, Emerging Infections Program Network, Group B Streptococcus, 2008. Atlanta, GA: US Department of Health and Human Services, CDC; 2009. Available at cdc.gov.
- ↑ Baker CJ, Barrett FF (1974). "Group B streptococcal infections in infants. The importance of the various serotypes". JAMA. 230 (8): 1158–60. PMID 4608888.