Group B streptococcal disease in UK and Irish infants younger than 90 days, 2014–15: a prospective surveillance study

Catherine P. O'Sullivan*, Theresa Lamagni, Darshana Patel, Androulla Efstratiou, Robert Cunney, Mary Meehan, Shamez Ladhani, Arlene J. Reynolds, Ruth Campbell, Lorraine Doherty, Margaret Boyle, Georgia Kapatai, Victoria Chalker, Diane Lindsay, Andrew Smith, Eleri Davies, Christine E. Jones, Paul T. Heath

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

32 Citations (Scopus)

Abstract

Background: Group B streptococcus is a leading cause of serious infection in young infants in many countries worldwide. We aimed to define the burden and clinical features of invasive group B streptococcal disease in infants younger than 90 days in the UK and Ireland, together with the characteristics of disease-causing isolates. Methods: Prospective, active national surveillance of invasive group B streptococcal disease in infants younger than 90 days was done from April 1, 2014, to April 30, 2015, through the British Paediatric Surveillance Unit, microbiology reference laboratories, and national public health agencies in the UK and Ireland. Early onset was defined as disease in the first 6 days of life and late onset was defined as 7–89 days of life. Incidence was calculated using livebirths in 2014 (after adjustment for the 13-month surveillance period). Isolates were characterised by serotyping, multilocus sequence typing, and antimicrobial susceptibility testing. Findings: 856 cases of group B streptococcus were identified in 2014–15, an incidence of 0·94 per 1000 livebirths (95% CI 0·88–1·00). Incidence for early-onset disease (n=517) was 0·57 per 1000 livebirths (95% CI 0·52–0·62), and for late-onset disease (n=339) was 0·37 per 1000 livebirths (0·33–0·41). 53 infants died (case fatality rate 6·2%), of whom 27 had early-onset disease (case fatality rate 5·2%) and 26 had late-onset disease (case fatality rate 7·7%). The predominant serotypes were III (241 [60%] of 402 serotyped isolates) and Ia (69 [17%]); five serotypes (Ia, Ib, II, III, V) accounted for 377 (94%) of all serotyped isolates. Interpretation: The incidence of invasive infant group B streptococcal disease in the UK and Ireland has increased since a comparable study done in 2000–01. The burden of early-onset disease has not declined despite the introduction of national prevention guidelines. New strategies for prevention are required. Funding: Meningitis Now.

Original languageEnglish
Pages (from-to)83-90
Number of pages8
JournalThe Lancet Infectious Diseases
Volume19
Issue number1
DOIs
Publication statusPublished - Jan 2019

Bibliographical note

Funding Information:
The study was funded by a grant from Meningitis Now. We would like to acknowledge the British Paediatric Surveillance Unit, and all the paediatricians, neonatologists, and microbiologists who have assisted in the study. Additionally, we would like to acknowledge Nader Mozakka, Bevan Loon, and Nick Hinton (Public Health England); Diogo Marques and Ross Cameron (Health Protection Scotland); Stephen Murchan (Health Protection Surveillance Centre); Marian Knight and Melanie O'Connor (UK Obstetric Surveillance System); Shrey Mathur and Maxine Ng (St George's Paediatric Infectious Diseases Research Group); and Sandra Morgan (Irish Meningitis and Sepsis Reference Laboratory). We also acknowledge Chenchal Dhami, Roger Daniel, and Karen Broughton for serotyping and DNA extraction, and Sophie Compton and Rachel Pike for assistance with inducible resistance testing (Public Health England).

Publisher Copyright:
© 2019 Elsevier Ltd

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