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Bacterial Load and Molecular Markers Associated With Early-onset Group B Streptococcus: A Systematic Review and Meta-analysis.

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journal contribution
posted on 24.04.2019, 11:46 by F Seedat, CS Brown, C Stinton, J Patterson, J Geppert, K Freeman, B Tan, SA Johnson, H Fraser, OA Uthman, ER Robinson, ND McCarthy, A Clarke, S Taylor-Phillips
BACKGROUND: The natural history of neonatal group B Streptococcus (GBS) is poorly understood. Little is known about the bacterial factors influencing the transmission of GBS from mother to neonate, or the development of invasive early-onset GBS disease (EOGBS) in colonized neonates. We reviewed whether bacterial load and molecular markers are associated with GBS vertical transmission and progression to EOGBS. METHODS: We searched Medline, Embase, Cochrane and Web of Science from inception to October 10, 2016, for observational studies in English. We also hand-searched reference lists of relevant publications and experts cross-checked included studies. Two reviewers independently screened studies, extracted data and appraised the quality of included studies using the Quality in Prognosis Studies tool. We conducted random-effects meta-analyses where possible and narratively synthesized the evidence in text and tables. RESULTS: Seventeen studies were included from 1107 records retrieved from electronic databases and publication references. Meta-analyses of 3 studies showed that neonates colonized by serotype III had a higher risk of developing EOGBS than serotype Ia (pooled risk ratio: 1.51, 95% confidence interval: 1.12-2.03) and serotype II (risk ratio: 1.95, 95% confidence interval: 1.10-3.45). Eleven studies showed that in heavily colonized mothers, 2-3 times more neonates were colonized, and in heavily colonized neonates, up to 15 times more neonates had EOGBS, compared with light colonization. Most evidence was published before 2000 and was at risk of bias. CONCLUSIONS: Acknowledging the difficulty of natural history studies, well-controlled studies are needed to assess the predictive value of pathogen subtype and heavy load; they may be useful for better-targeted prevention.

History

Citation

Pediatric Infectious Disease Journal, 2018, 37 (12), pp. e306-e314

Author affiliation

/Organisation/COLLEGE OF LIFE SCIENCES/School of Medicine/Department of Cardiovascular Sciences

Version

VoR (Version of Record)

Published in

Pediatric Infectious Disease Journal

Publisher

Lippincott, Williams & Wilkins for European Society for Paediatric Infectious Diseases (ESPID), Pediatric Infectious Diseases Society (PIDS)

eissn

1532-0987

Acceptance date

14/01/2018

Copyright date

2018

Available date

24/04/2019

Publisher version

https://insights.ovid.com/crossref?an=00006454-201812000-00028

Language

en