Group B streptococcal infection epidemiology and demographics
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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
GBS in Pregnancy
Approximately 10%--30% of pregnant women are colonized with GBS in the vagina or rectum.[7][8][9]
GBS in Neonates
Incidence
Before active prevention was initiated, an estimated 7,500 cases of neonatal GBS disease occurred annually in the United States.[2]
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;[10] approximately 70% of cases are among babies born at term (≥37 weeks' gestation).[1]
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[11] 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.
- ↑ 2.0 2.1 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
- ↑ Regan JA, Klebanoff MA, Nugent RP (1991). "The epidemiology of group B streptococcal colonization in pregnancy. Vaginal Infections and Prematurity Study Group". Obstet Gynecol. 77 (4): 604–10. PMID 2002986.
- ↑ Yancey MK, Schuchat A, Brown LK, Ventura VL, Markenson GR (1996). "The accuracy of late antenatal screening cultures in predicting genital group B streptococcal colonization at delivery". Obstet Gynecol. 88 (5): 811–5. doi:10.1016/0029-7844(96)00320-1. PMID 8885919.
- ↑ Campbell JR, Hillier SL, Krohn MA, Ferrieri P, Zaleznik DF, Baker CJ (2000). "Group B streptococcal colonization and serotype-specific immunity in pregnant women at delivery". Obstet Gynecol. 96 (4): 498–503. PMID 11004347.
- ↑ 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.