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Group B S treptococcal infection in the first 90 days of life in N orth Q ueensland
Author(s) -
Ireland Susan,
Larkins Sarah,
Kandasamy Yogavijayan
Publication year - 2014
Publication title -
australian and new zealand journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.734
H-Index - 65
eISSN - 1479-828X
pISSN - 0004-8666
DOI - 10.1111/ajo.12150
Subject(s) - medicine , incidence (geometry) , group b , caesarean section , pregnancy , pediatrics , apgar score , obstetrics , risk factor , retrospective cohort study , neonatal sepsis , sepsis , birth weight , surgery , physics , biology , optics , genetics
Background Group B S treptococcus ( GBS ) infection is recognised as an important cause for neonatal sepsis. Aims To describe the incidence and risk factors for invasive GBS under 90 days of age in N orth Q ueensland from J anuary 2002 to D ecember 2011. Material and Methods Patients were identified with positive blood and cerebrospinal fluid cultures to obtain incidence figures. The T ownsville district cohort was further investigated for the presence of maternal and fetal risk factors in a retrospective case‐controlled study. Results Early onset GBS continues to occur at 0.43/1000 live births, and late onset disease at 0.38/1000 live births. Early onset GBS and late onset GBS are shown to be two distinct diseases. Early onset disease is significantly different from the control group for these risk factors: previous late fetal loss, prolonged rupture of membranes, inadequate intrapartum antibiotics, abnormal cardiotocography, delivery by emergency c aesarean section, lower one minute A pgar scores and need for resuscitation at delivery. Significant variables for late onset disease are earlier gestation and need for resuscitation at birth, first born babies, multiple pregnancy and birth by emergency c aesarean section. The incidence of early or late onset GBS in Aboriginal or Torres Strait Islanders was not significantly different. Conclusions Group B Streptococcus continues to occur in N orth Q ueensland at higher than expected rates, and a new approach to its prevention should be considered. Previous fetal loss may be a risk factor which is under recognised. Babies with late onset infection appear to be significantly more preterm.