Lubna Hamdan1, Simon Vandekar2, Andrew J Spieker2, Herdi Rahman1, Danielle Ndi3, Emily S Shekarabi1, Jyotsna Thota1, Danielle A Rankin1,4, Zaid Haddadin1, Tiffanie Markus3, David M Aronoff5,6,7, William Schaffner3, Jennifer A Gaddy5,6,8, Natasha B Halasa1. 1. Department of Pediatric Infectious Diseases, Vanderbilt University Medical Center, Nashville, Tennessee, USA. 2. Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee, USA. 3. Department of Health Policy, Vanderbilt University Medical Center, Nashville, Tennessee, USA. 4. Vanderbilt Epidemiology PhD Program, Vanderbilt University School of Medicine, Nashville, Tennessee, USA. 5. Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee, USA. 6. Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA. 7. Department of Obstetrics and Gynecology, Vanderbilt University Medical Center, Nashville, Tennessee, USA. 8. Tennessee Valley Healthcare Systems, Department of Veterans Affairs, Nashville, Tennessee, USA.
Abstract
BACKGROUND: The rates of early-onset group B Streptococcus (GBS) disease (EOGBS) have declined since the implementation of universal screening and intrapartum antibiotic prophylaxis guidelines but late-onset (LOGBS) rates remain unchanged. Racial differences in GBS disease rates have been previously documented, with Black infants having higher rates of EOGBS and LOGBS, but it is not known if these have persisted. Therefore, we sought to determine the differences in EOGBS and LOGBS disease by race over the past decade in Tennessee. METHODS: This study used active population-based and laboratory-based surveillance data for invasive GBS disease conducted through Active Bacterial Core surveillance in selected counties across Tennessee. We included infants younger than 90 days and who had invasive GBS disease between 2009 and 2018. RESULTS: A total of 356 GBS cases were included, with 60% having LOGBS. EOGBS and LOGBS had decreasing temporal trends over the study period. Overall, there were no changes in temporal trend noted in the rates of EOGBS and LOGBS among White infants. However, Black infants had significantly decreasing EOGBS and LOGBS temporal trends (relative risk [95% confidence interval], .87 [.79, .96] [P = .007] and .90 [.84-.97] [P = .003], respectively). CONCLUSIONS: Years after the successful implementation of the universal screening guidelines, our data revealed an overall decrease in LOGBS rates, primarily driven by changes among Black infants. More studies are needed to characterize the racial disparities in GBS rates, and factors driving them. Prevention measures such as vaccination are needed to have a further impact on disease rates.
BACKGROUND: The rates of early-onset group B Streptococcus (GBS) disease (EOGBS) have declined since the implementation of universal screening and intrapartum antibiotic prophylaxis guidelines but late-onset (LOGBS) rates remain unchanged. Racial differences in GBS disease rates have been previously documented, with Black infants having higher rates of EOGBS and LOGBS, but it is not known if these have persisted. Therefore, we sought to determine the differences in EOGBS and LOGBS disease by race over the past decade in Tennessee. METHODS: This study used active population-based and laboratory-based surveillance data for invasive GBS disease conducted through Active Bacterial Core surveillance in selected counties across Tennessee. We included infants younger than 90 days and who had invasive GBS disease between 2009 and 2018. RESULTS: A total of 356 GBS cases were included, with 60% having LOGBS. EOGBS and LOGBS had decreasing temporal trends over the study period. Overall, there were no changes in temporal trend noted in the rates of EOGBS and LOGBS among White infants. However, Black infants had significantly decreasing EOGBS and LOGBS temporal trends (relative risk [95% confidence interval], .87 [.79, .96] [P = .007] and .90 [.84-.97] [P = .003], respectively). CONCLUSIONS: Years after the successful implementation of the universal screening guidelines, our data revealed an overall decrease in LOGBS rates, primarily driven by changes among Black infants. More studies are needed to characterize the racial disparities in GBS rates, and factors driving them. Prevention measures such as vaccination are needed to have a further impact on disease rates.
Authors: Hannah T Jordan; Monica M Farley; Allen Craig; Janet Mohle-Boetani; Lee H Harrison; Susan Petit; Ruth Lynfield; Ann Thomas; Shelley Zansky; Kenneth Gershman; Bernadette A Albanese; William Schaffner; Stephanie J Schrag Journal: Pediatr Infect Dis J Date: 2008-12 Impact factor: 2.129
Authors: A Schuchat; T Hilger; E Zell; M M Farley; A Reingold; L Harrison; L Lefkowitz; R Danila; K Stefonek; N Barrett; D Morse; R Pinner Journal: Emerg Infect Dis Date: 2001 Jan-Feb Impact factor: 6.883
Authors: Lola Madrid; Anna C Seale; Maya Kohli-Lynch; Karen M Edmond; Joy E Lawn; Paul T Heath; Shabir A Madhi; Carol J Baker; Linda Bartlett; Clare Cutland; Michael G Gravett; Margaret Ip; Kirsty Le Doare; Craig E Rubens; Samir K Saha; Ajoke Sobanjo-Ter Meulen; Johan Vekemans; Stephanie Schrag Journal: Clin Infect Dis Date: 2017-11-06 Impact factor: 20.999