Epidemiology of Late and Very Late Onset Group B Streptococcal Disease: Fifteen-Year Experience From Two Australian Tertiary Pediatric Facilities
BACKGROUND:Group B Streptococcus (GBS) is a recognized cause of sepsis and meningitis, particularly in infants. Early onset (
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| Veröffentlicht in: | The Pediatric infectious disease journal 2017-01, Vol.36 (1), p.20-24 |
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| container_title | The Pediatric infectious disease journal |
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| creator | Bartlett, Adam W Smith, Ben George, C. R Robert McMullan, Brendan Kesson, Alison Lahra, Monica M Palasanthiran, Pamela |
| description | BACKGROUND:Group B Streptococcus (GBS) is a recognized cause of sepsis and meningitis, particularly in infants. Early onset ( |
| doi_str_mv | 10.1097/INF.0000000000001345 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1835442015</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1835442015</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3565-7371da034ca4068fdcffc08fcd965534e4aa88693753386b8cffa8e17539a4023</originalsourceid><addsrcrecordid>eNp9UcFO3DAQtaqisl36B1XlYy8Be-0kTm8UNoC0KkhdKvUUDc6kGJw42I4WPqN_XKMFhHpgLqPRvPdGbx4hnznb56wqD85-1PvsVXEh83dkxnOxyFilyvdkxlTFM1EUapd8DOEmgYTk7APZXZSlrIo8n5G_y9G02Btn3Z8H6jq6gogUhpb-Qv-wnc6HgJGeeDeN9Dv9GT2O0WmnNVh6bAJCwG-0Nl1EHLLfCJ4u70f0BgeNtPaup-uNo4dTiB6sgYGu0UcDSf4CWwPRG01r0MaaaDDskZ0ObMBPT31OLuvl-ug0W52fnB0drjIt8iLPSlHyFpIhDZIVqmt112mmOt0-GhMSJYBSRSXKXAhVXKm0B4U8jVViLMScfN3qjt7dTRhi05ug0VoY0E2h4UrkUi5YeuicyC1UexeCx64ZvemTgYaz5jGMJoXR_B9Gon15ujBd9di-kJ6_nwBqC9g4G9GHWztt0DfXCDZev639D0BzluA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1835442015</pqid></control><display><type>article</type><title>Epidemiology of Late and Very Late Onset Group B Streptococcal Disease: Fifteen-Year Experience From Two Australian Tertiary Pediatric Facilities</title><source>MEDLINE</source><source>Journals@Ovid Complete</source><creator>Bartlett, Adam W ; Smith, Ben ; George, C. R Robert ; McMullan, Brendan ; Kesson, Alison ; Lahra, Monica M ; Palasanthiran, Pamela</creator><creatorcontrib>Bartlett, Adam W ; Smith, Ben ; George, C. R Robert ; McMullan, Brendan ; Kesson, Alison ; Lahra, Monica M ; Palasanthiran, Pamela</creatorcontrib><description>BACKGROUND:Group B Streptococcus (GBS) is a recognized cause of sepsis and meningitis, particularly in infants. Early onset (<7 days) GBS disease has been well characterized, whereas the epidemiology of late onset disease (LOD, 7–89 days) and very late onset disease (VLOD, ≥90 days) is less well understood. The aims of this study were to assess risk factors, presentation, management and outcome for GBS LOD and VLOD.
METHODS:Microbiology laboratory databases and hospital diagnostic coding for Sydney Children’s Hospital and the Children’s Hospital at Westmead were investigated for patients ≥7 days of age diagnosed with GBS bloodstream infection or meningitis from January 1, 2000 to December 31, 2014 (15 years). Subjects’ medical records were reviewed to confirm diagnosis and analyze risk factors, presentation, management and outcome.
RESULTS:Eighty-seven cases of LOD and 28 cases of VLOD were identified, including 49 cases of bloodstream infection and 66 cases of meningitis. No significant differences in risk factors or presentation were identified between LOD and VLOD. Patients with LOD were more likely to develop sequelae compared with VLOD [odds ratio (OR)3, 95% confidence interval (CI)1.03–8.77]. Female sex was the only significant risk factor identified for GBS meningitis (OR3.5, 95% CI1.5–8.1). GBS meningitis was significantly associated with neurodevelopmental impairment or death compared with bloodstream infection (OR30, 95% CI6.4–140.6).
CONCLUSIONS:GBS LOD and VLOD are encountered in similar at-risk populations, with LOD associated with higher morbidity. Infants presenting with meningitis are at significantly higher risk of sequelae compared with bloodstream infection.</description><identifier>ISSN: 0891-3668</identifier><identifier>EISSN: 1532-0987</identifier><identifier>DOI: 10.1097/INF.0000000000001345</identifier><identifier>PMID: 27749655</identifier><language>eng</language><publisher>United States: Copyright Wolters Kluwer Health, Inc. All rights reserved</publisher><subject>Australia - epidemiology ; Bacteremia - epidemiology ; Bacteremia - microbiology ; Bacteremia - mortality ; Bacteremia - therapy ; Child, Preschool ; Female ; Hospitals, Pediatric ; Humans ; Infant ; Infant, Newborn ; Male ; Meningitis, Bacterial - epidemiology ; Meningitis, Bacterial - microbiology ; Meningitis, Bacterial - mortality ; Meningitis, Bacterial - therapy ; Retrospective Studies ; Risk Factors ; Streptococcal Infections - epidemiology ; Streptococcal Infections - microbiology ; Streptococcal Infections - mortality ; Streptococcal Infections - therapy ; Streptococcus agalactiae</subject><ispartof>The Pediatric infectious disease journal, 2017-01, Vol.36 (1), p.20-24</ispartof><rights>Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3565-7371da034ca4068fdcffc08fcd965534e4aa88693753386b8cffa8e17539a4023</citedby><cites>FETCH-LOGICAL-c3565-7371da034ca4068fdcffc08fcd965534e4aa88693753386b8cffa8e17539a4023</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,781,785,27928,27929</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27749655$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bartlett, Adam W</creatorcontrib><creatorcontrib>Smith, Ben</creatorcontrib><creatorcontrib>George, C. R Robert</creatorcontrib><creatorcontrib>McMullan, Brendan</creatorcontrib><creatorcontrib>Kesson, Alison</creatorcontrib><creatorcontrib>Lahra, Monica M</creatorcontrib><creatorcontrib>Palasanthiran, Pamela</creatorcontrib><title>Epidemiology of Late and Very Late Onset Group B Streptococcal Disease: Fifteen-Year Experience From Two Australian Tertiary Pediatric Facilities</title><title>The Pediatric infectious disease journal</title><addtitle>Pediatr Infect Dis J</addtitle><description>BACKGROUND:Group B Streptococcus (GBS) is a recognized cause of sepsis and meningitis, particularly in infants. Early onset (<7 days) GBS disease has been well characterized, whereas the epidemiology of late onset disease (LOD, 7–89 days) and very late onset disease (VLOD, ≥90 days) is less well understood. The aims of this study were to assess risk factors, presentation, management and outcome for GBS LOD and VLOD.
METHODS:Microbiology laboratory databases and hospital diagnostic coding for Sydney Children’s Hospital and the Children’s Hospital at Westmead were investigated for patients ≥7 days of age diagnosed with GBS bloodstream infection or meningitis from January 1, 2000 to December 31, 2014 (15 years). Subjects’ medical records were reviewed to confirm diagnosis and analyze risk factors, presentation, management and outcome.
RESULTS:Eighty-seven cases of LOD and 28 cases of VLOD were identified, including 49 cases of bloodstream infection and 66 cases of meningitis. No significant differences in risk factors or presentation were identified between LOD and VLOD. Patients with LOD were more likely to develop sequelae compared with VLOD [odds ratio (OR)3, 95% confidence interval (CI)1.03–8.77]. Female sex was the only significant risk factor identified for GBS meningitis (OR3.5, 95% CI1.5–8.1). GBS meningitis was significantly associated with neurodevelopmental impairment or death compared with bloodstream infection (OR30, 95% CI6.4–140.6).
CONCLUSIONS:GBS LOD and VLOD are encountered in similar at-risk populations, with LOD associated with higher morbidity. Infants presenting with meningitis are at significantly higher risk of sequelae compared with bloodstream infection.</description><subject>Australia - epidemiology</subject><subject>Bacteremia - epidemiology</subject><subject>Bacteremia - microbiology</subject><subject>Bacteremia - mortality</subject><subject>Bacteremia - therapy</subject><subject>Child, Preschool</subject><subject>Female</subject><subject>Hospitals, Pediatric</subject><subject>Humans</subject><subject>Infant</subject><subject>Infant, Newborn</subject><subject>Male</subject><subject>Meningitis, Bacterial - epidemiology</subject><subject>Meningitis, Bacterial - microbiology</subject><subject>Meningitis, Bacterial - mortality</subject><subject>Meningitis, Bacterial - therapy</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Streptococcal Infections - epidemiology</subject><subject>Streptococcal Infections - microbiology</subject><subject>Streptococcal Infections - mortality</subject><subject>Streptococcal Infections - therapy</subject><subject>Streptococcus agalactiae</subject><issn>0891-3668</issn><issn>1532-0987</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9UcFO3DAQtaqisl36B1XlYy8Be-0kTm8UNoC0KkhdKvUUDc6kGJw42I4WPqN_XKMFhHpgLqPRvPdGbx4hnznb56wqD85-1PvsVXEh83dkxnOxyFilyvdkxlTFM1EUapd8DOEmgYTk7APZXZSlrIo8n5G_y9G02Btn3Z8H6jq6gogUhpb-Qv-wnc6HgJGeeDeN9Dv9GT2O0WmnNVh6bAJCwG-0Nl1EHLLfCJ4u70f0BgeNtPaup-uNo4dTiB6sgYGu0UcDSf4CWwPRG01r0MaaaDDskZ0ObMBPT31OLuvl-ug0W52fnB0drjIt8iLPSlHyFpIhDZIVqmt112mmOt0-GhMSJYBSRSXKXAhVXKm0B4U8jVViLMScfN3qjt7dTRhi05ug0VoY0E2h4UrkUi5YeuicyC1UexeCx64ZvemTgYaz5jGMJoXR_B9Gon15ujBd9di-kJ6_nwBqC9g4G9GHWztt0DfXCDZev639D0BzluA</recordid><startdate>201701</startdate><enddate>201701</enddate><creator>Bartlett, Adam W</creator><creator>Smith, Ben</creator><creator>George, C. R Robert</creator><creator>McMullan, Brendan</creator><creator>Kesson, Alison</creator><creator>Lahra, Monica M</creator><creator>Palasanthiran, Pamela</creator><general>Copyright Wolters Kluwer Health, Inc. All rights reserved</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201701</creationdate><title>Epidemiology of Late and Very Late Onset Group B Streptococcal Disease: Fifteen-Year Experience From Two Australian Tertiary Pediatric Facilities</title><author>Bartlett, Adam W ; Smith, Ben ; George, C. R Robert ; McMullan, Brendan ; Kesson, Alison ; Lahra, Monica M ; Palasanthiran, Pamela</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3565-7371da034ca4068fdcffc08fcd965534e4aa88693753386b8cffa8e17539a4023</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Australia - epidemiology</topic><topic>Bacteremia - epidemiology</topic><topic>Bacteremia - microbiology</topic><topic>Bacteremia - mortality</topic><topic>Bacteremia - therapy</topic><topic>Child, Preschool</topic><topic>Female</topic><topic>Hospitals, Pediatric</topic><topic>Humans</topic><topic>Infant</topic><topic>Infant, Newborn</topic><topic>Male</topic><topic>Meningitis, Bacterial - epidemiology</topic><topic>Meningitis, Bacterial - microbiology</topic><topic>Meningitis, Bacterial - mortality</topic><topic>Meningitis, Bacterial - therapy</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Streptococcal Infections - epidemiology</topic><topic>Streptococcal Infections - microbiology</topic><topic>Streptococcal Infections - mortality</topic><topic>Streptococcal Infections - therapy</topic><topic>Streptococcus agalactiae</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bartlett, Adam W</creatorcontrib><creatorcontrib>Smith, Ben</creatorcontrib><creatorcontrib>George, C. R Robert</creatorcontrib><creatorcontrib>McMullan, Brendan</creatorcontrib><creatorcontrib>Kesson, Alison</creatorcontrib><creatorcontrib>Lahra, Monica M</creatorcontrib><creatorcontrib>Palasanthiran, Pamela</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Pediatric infectious disease journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bartlett, Adam W</au><au>Smith, Ben</au><au>George, C. R Robert</au><au>McMullan, Brendan</au><au>Kesson, Alison</au><au>Lahra, Monica M</au><au>Palasanthiran, Pamela</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Epidemiology of Late and Very Late Onset Group B Streptococcal Disease: Fifteen-Year Experience From Two Australian Tertiary Pediatric Facilities</atitle><jtitle>The Pediatric infectious disease journal</jtitle><addtitle>Pediatr Infect Dis J</addtitle><date>2017-01</date><risdate>2017</risdate><volume>36</volume><issue>1</issue><spage>20</spage><epage>24</epage><pages>20-24</pages><issn>0891-3668</issn><eissn>1532-0987</eissn><abstract>BACKGROUND:Group B Streptococcus (GBS) is a recognized cause of sepsis and meningitis, particularly in infants. Early onset (<7 days) GBS disease has been well characterized, whereas the epidemiology of late onset disease (LOD, 7–89 days) and very late onset disease (VLOD, ≥90 days) is less well understood. The aims of this study were to assess risk factors, presentation, management and outcome for GBS LOD and VLOD.
METHODS:Microbiology laboratory databases and hospital diagnostic coding for Sydney Children’s Hospital and the Children’s Hospital at Westmead were investigated for patients ≥7 days of age diagnosed with GBS bloodstream infection or meningitis from January 1, 2000 to December 31, 2014 (15 years). Subjects’ medical records were reviewed to confirm diagnosis and analyze risk factors, presentation, management and outcome.
RESULTS:Eighty-seven cases of LOD and 28 cases of VLOD were identified, including 49 cases of bloodstream infection and 66 cases of meningitis. No significant differences in risk factors or presentation were identified between LOD and VLOD. Patients with LOD were more likely to develop sequelae compared with VLOD [odds ratio (OR)3, 95% confidence interval (CI)1.03–8.77]. Female sex was the only significant risk factor identified for GBS meningitis (OR3.5, 95% CI1.5–8.1). GBS meningitis was significantly associated with neurodevelopmental impairment or death compared with bloodstream infection (OR30, 95% CI6.4–140.6).
CONCLUSIONS:GBS LOD and VLOD are encountered in similar at-risk populations, with LOD associated with higher morbidity. Infants presenting with meningitis are at significantly higher risk of sequelae compared with bloodstream infection.</abstract><cop>United States</cop><pub>Copyright Wolters Kluwer Health, Inc. All rights reserved</pub><pmid>27749655</pmid><doi>10.1097/INF.0000000000001345</doi><tpages>5</tpages></addata></record> |
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| ispartof | The Pediatric infectious disease journal, 2017-01, Vol.36 (1), p.20-24 |
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| source | MEDLINE; Journals@Ovid Complete |
| subjects | Australia - epidemiology Bacteremia - epidemiology Bacteremia - microbiology Bacteremia - mortality Bacteremia - therapy Child, Preschool Female Hospitals, Pediatric Humans Infant Infant, Newborn Male Meningitis, Bacterial - epidemiology Meningitis, Bacterial - microbiology Meningitis, Bacterial - mortality Meningitis, Bacterial - therapy Retrospective Studies Risk Factors Streptococcal Infections - epidemiology Streptococcal Infections - microbiology Streptococcal Infections - mortality Streptococcal Infections - therapy Streptococcus agalactiae |
| title | Epidemiology of Late and Very Late Onset Group B Streptococcal Disease: Fifteen-Year Experience From Two Australian Tertiary Pediatric Facilities |
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