Group B streptococcal infection natural history: Difference between revisions
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==Overview== | ==Overview== | ||
GBS is the leading infectious cause of [[morbidity]] and mortality among infants in the United States, particularly among preterm neonates.<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><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> Most newborns with early-onset disease have symptoms on the day of birth. Babies who develop late-onset disease may appear healthy at birth and develop symptoms of group B strep disease after the first week of life. | |||
==Natural History== | ==Natural History== | ||
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====Mortality==== | ====Mortality==== | ||
GBS is the leading infectious cause of [[morbidity]] and mortality among infants in the United States. 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% | GBS is the leading infectious cause of [[morbidity]] and mortality among infants in the United States. 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> | [[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> | ||
Revision as of 11:14, 21 August 2014
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [2]; Associate Editor(s)-in-Chief: Rim Halaby, M.D. [3]
Overview
GBS is the leading infectious cause of morbidity and mortality among infants in the United States, particularly among preterm neonates.[1][2][3] Most newborns with early-onset disease have symptoms on the day of birth. Babies who develop late-onset disease may appear healthy at birth and develop symptoms of group B strep disease after the first week of life.
Natural History
GBS in Neonates
Most newborns with early-onset disease have symptoms on the day of birth. Babies who develop late-onset disease may appear healthy at birth and develop symptoms of group B strep disease after the first week of life. Infants with early-onset GBS disease generally present with respiratory distress, apnea, or other signs of sepsis within the first 24--48 hours of life.[4] The most common clinical syndromes of early-onset disease are sepsis and pneumonia; less frequently, early-onset infections can lead to meningitis.
Mortality
GBS is the leading infectious cause of morbidity and mortality among infants in the United States. The case-fatality ratio of early-onset disease has declined from as high as 50% in the 1970s[1] to 4%-6% in recent years, primarily because of advances in neonatal care.[2][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.[2][3]
GBS in Pregnancy
GBS colonization during pregnancy can be transient, intermittent, or persistent. Although some women with GBS colonization during a pregnancy will be colonized during subsequent pregnancies, a substantial proportion will not.[5][6] In the absence of any intervention, an estimated 1%-2% of infants born to colonized mothers develop early-onset GBS infections.[7][8]
References
- ↑ 1.0 1.1 Baker CJ, Barrett FF (1974). "Group B streptococcal infections in infants. The importance of the various serotypes". JAMA. 230 (8): 1158–60. PMID 4608888.
- ↑ 2.0 2.1 2.2 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.
- ↑ 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.
- ↑ Franciosi RA, Knostman JD, Zimmerman RA (1973). "Group B streptococcal neonatal and infant infections". J Pediatr. 82 (4): 707–18. PMID 4572747.
- ↑ Cheng PJ, Chueh HY, Liu CM, Hsu JJ, Hsieh TT, Soong YK (2008). "Risk factors for recurrence of group B streptococcus colonization in a subsequent pregnancy". Obstet Gynecol. 111 (3): 704–9. doi:10.1097/AOG.0b013e318163cd6b. PMID 18310374.
- ↑ Turrentine MA, Ramirez MM (2008). "Recurrence of group B streptococci colonization in subsequent pregnancy". Obstet Gynecol. 112 (2 Pt 1): 259–64. doi:10.1097/AOG.0b013e31817f5cb9. PMID 18669720.
- ↑ CDC. Prevention of perinatal group B streptococcal disease: a public health perspective. MMWR 1996;45(No. RR-7).[1]
- ↑ Boyer KM, Gotoff SP (1985). "Strategies for chemoprophylaxis of GBS early-onset infections". Antibiot Chemother (1971). 35: 267–80. PMID 3931544.