Intrapartum Antibiotics Reduce Infant Strep B Infection Globally

Emphasis on prophylactic use of intrapartum antibiotics needed in low-income settings

THURSDAY, Jan. 5 (HealthDay News) -- Intrapartum prophylactic antibiotics substantially reduce infant streptococcus B infection worldwide, but the practice should be more widely adopted in low-income settings, according to research published online Jan. 5 in The Lancet.

Karen M. Edmond, Ph.D., of the London School of Hygiene and Tropical Medicine, and colleagues conducted a review and meta-analysis of 74 studies that analyzed the global burden and serotype distribution of invasive early-onset (zero to six days) and late-onset (seven to 89 days) group B streptococcal disease in infants. Only five developing nations were represented in the study and contributed 5 percent weight to the meta-analysis.

The researchers found that 69 percent of studies reported any prophylactic use of intrapartum antibiotic. Mean incidence of group B streptococcus in infants aged 0 to 89 days was 0.53 per 1,000 live births, and the mean case fatality ratio was 9.6 percent. Incidence (0.43 per 1,000 live births) and case fatality (12.1 percent) for early-onset group B streptococcal disease were two times higher than for late-onset disease. The most frequently seen serotype in all regions was III (48.9 percent), followed by serotypes Ia (22.9 percent), Ib (7.0 percent), II (6.2 percent), and V (9.1 percent). Studies that reported any intrapartum antibiotic prophylaxis showed lower incidence of early-onset group B streptococcus (0.23 per 1,000 live births) than studies in which mothers did not receive prophylaxis (0.75 per 1,000 live births).

"A conjugate vaccine incorporating five serotypes (Ia, Ib, II, III, V) could prevent most global group B streptococcal disease," the authors write.

One of the authors disclosed financial ties to a group B streptococcus vaccine manufacturer.

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