Document Detail


Early-onset neonatal group B streptococcal infections in New Zealand 1998-1999.
MedLine Citation:
PMID:  12047696     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To determine in New Zealand infants the attack rates, risk factors, preventive policies, strain serotype and antibiotic susceptibilities of early-onset neonatal group B streptococcus (GBS) infection. METHOD: A 2-year prospective active surveillance study was conducted in New Zealand's 19 neonatal units. Cases had to present within 48 h of delivery, be unwell, possess abnormal haematological indices and have GBS isolated from sterile sites. RESULTS: Of the 112 402 infants born in New Zealand during 1998-1999, 56 had early-onset GBS infection, an attack rate of 0.5 per 1000 live births (95% confidence interval [CI] 0.38, 0.65). Seven had meningitis and there was one death (case fatality rate of 1.8%; upper 95% CI 9.5%). Univariate analysis identified young maternal age, parity, preterm labour, prolonged membrane rupture, maternal fever and assisted delivery as risk factors. Preventive policies for GBS were reported by 14 (74%) obstetric centres associated with neonatal units. Of the 56 cases, five (9%) were born to mothers receiving intrapartum antibiotics, 32 (57%) had mothers with risk factors but were not treated with antibiotics, and 19 (34%) were born to mothers without identifiable risk factors for GBS prevention. Serotypes Ia and III predominated, while two isolates were resistant to erythromycin and/or clindamycin. CONCLUSIONS: Rates of early-onset GBS infection are similar to other countries following the introduction of prevention policies. Further reductions are possible with full implementation of these guidelines. Meanwhile, emergence of antibiotic resistance complicates the management of women with penicillin allergy. Vaccine development therefore remains a priority.
Authors:
K Grimwood; B A Darlow; I A Gosling; R Green; D R Lennon; D R Martin; P R Stone
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of paediatrics and child health     Volume:  38     ISSN:  1034-4810     ISO Abbreviation:  J Paediatr Child Health     Publication Date:  2002 Jun 
Date Detail:
Created Date:  2002-06-05     Completed Date:  2002-09-09     Revised Date:  2007-09-24    
Medline Journal Info:
Nlm Unique ID:  9005421     Medline TA:  J Paediatr Child Health     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  272-7     Citation Subset:  IM    
Affiliation:
Department of Paediatrics and Child Health, Wellington School of Medicine and Health Sciences, Wellington, New Zealand. grimwood@wnmeds.ac.nz
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MeSH Terms
Descriptor/Qualifier:
Adult
Analysis of Variance
Anti-Bacterial Agents / administration & dosage
Cohort Studies
Confidence Intervals
Cross Infection / diagnosis,  epidemiology
Drug Resistance, Microbial*
Female
Health Care Surveys
Humans
Incidence
Infant, Newborn
Intensive Care Units, Neonatal
Male
Maternal Age
Microbial Sensitivity Tests
Middle Aged
New Zealand / epidemiology
Obstetric Labor, Premature
Parity
Pregnancy
Risk Factors
Severity of Illness Index
Streptococcal Infections / drug therapy,  epidemiology*,  prevention & control
Streptococcus agalactiae / drug effects,  isolation & purification*
Time Factors
Chemical
Reg. No./Substance:
0/Anti-Bacterial Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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