Forthcoming Issue 3 Similar Mortality Rates for Early and Late Group B Streptococcal Disease in Newborns at Groote Schuur Hospital in Cape Town

Main Article Content

B Browne
L Tooke
A Khumalo

Abstract

Background. Invasive Group B Streptococcal disease (iGBS) is an important cause of morbidity and mortality in newborns globally, and is more common in Sub-Saharan Africa and South Africa. There are few studies reporting on the burden of iGBS in newborns in South Africa, especially in the Western Cape.


Objective. To describe all cases of newborn iGBS at Groote Schuur Hospital (GSH) in the Western Cape between January 2015 and December 2020.


Methods. A retrospective review was conducted of all blood or cerebrospinal fluid-confirmed cases of newborn iGBS between January 2015 and December 2020.  
Results. Thirty five cases of iGBS were included in the study, 51% with early-onset disease (EoD) and 49% with late-onset disease (LoD). The median gestational age at birth was 27 and 31.5 weeks in the LoD and EoD groups respectively. The median birth weight was 900 g and 1812 g in the LoD and EoD group respectively. Meningitis was more common in the LoD group, and pneumonia more common in the EoD group. The overall mortality rate was 23% with similar mortality rates in the EoD and LoD groups (22% for EoD and 24% for LoD). Invasive GBS disease accounted for a cumulative 274 days in the intensive care unit over the study period.


Conclusion. Invasive GBS disease in newborns at GSH carries a high mortality rate, and a similar mortality rate between EoD and LoD groups was observed in this study.

Article Details

How to Cite
Forthcoming Issue 3: Similar Mortality Rates for Early and Late Group B Streptococcal Disease in Newborns at Groote Schuur Hospital in Cape Town. (2024). South African Journal of Child Health, 18(2). https://doi.org/10.7196/
Section
Research
Author Biographies

B Browne, Department of Paediatrics and Child Health, University of Cape Town, South Africa

Paediatrician 

Department of Paediatrics, Red Cross War Memorial Children's Hospital, Cape Town, South Africa

L Tooke, Department of Paediatrics and Child Health, University of Cape Town, South Africa

Neonatologist

Department of Neonatology, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa

A Khumalo, University of Cape Town

Medical Microbiologist

Department of Medical Microbiology, Groote Schuur Hospital, Cape Town, South Africa

How to Cite

Forthcoming Issue 3: Similar Mortality Rates for Early and Late Group B Streptococcal Disease in Newborns at Groote Schuur Hospital in Cape Town. (2024). South African Journal of Child Health, 18(2). https://doi.org/10.7196/

References

Glaser P, Rusniok C, Buchrieser C, Chevalier F, Frangeul L, Msadek T, et al. Genome sequence of Streptococcus agalactiae, a pathogen causing invasive neonatal disease. Mol Microbiol. 2002;45(6):1499–513. https://doi.org/10.1046/j.1365-2958.2002.03126.x.

Seale AC, Bianchi-Jassir F, Russell NJ, Kohli-Lynch M, Tann CJ, Hall J, et al. Estimates of the Burden of Group B Streptococcal Disease Worldwide for Pregnant Women, Stillbirths, and Children. Clin Infect Dis. 2017;65(Suppl 2):S200–19. https://doi.org/10.1093/cid/cix664.

Gonçalves BP, Procter SR, Paul P, Chandna J, Lewin A, Seedat F, et al. Group B streptococcus infection during pregnancy and infancy: estimates of regional and global burden. Lancet Glob Heal. 2022;10(6):e807–19. https://doi.org/10.1016/s2214-109x(22)00093-6.

Kwatra G, Cunnington MC, Merrall E, Adrian P V., Ip M, Klugman KP, et al. Prevalence of maternal colonisation with group B streptococcus: a systematic review and meta-analysis. Lancet Infect Dis. 2016;16(9):1076–84. https://doi.org/10.1016/s1473-3099(16)30055-x.

Cutland CL, Schrag SJ, Thigpen MC, Velaphi SC, Wadula J, Adrian P V., et al. Increased risk for group b streptococcus sepsis in young infants exposed to HIV, soweto, south africa, 2004–2008. Emerg Infect Dis. 2015;21(4):638–45. https://doi.org/10.3201/eid2104.141562.

Fairlie T, Zell ER, Schrag S. Effectiveness of Intrapartum Antibiotic Prophylaxis for Prevention of Early-Onset Group B Streptococcal Disease. Obs Gynecol. 2013;121(3):570–7. https://doi.org/10.1097/aog.0b013e318280d4f6.

Quan V, Verani JR, Cohen C, Von Gottberg A, Meiring S, Cutland CL, et al. Invasive group B streptococcal disease in South Africa: Importance of surveillance methodology. PLoS One. 2016;11(4):1–10. https://doi.org/10.1371/journal.pone.0152524.

Sinha A, Russell LB, Tomczyk S, Verani JR, Schrag SJ, Berkley JA, et al. Disease Burden of Group B Streptococcus among Infants in sub-Saharan Africa: A Systematic Literature Review and Meta-Analysis. Pediatr Infect Dis J. 2016;35(9):933–42. https://doi.org/10.1097/inf.0000000000001233.

Edmond KM, Kortsalioudaki C, Scott S, Schrag SJ, Zaidi AK, Cousens S, et al. Group B streptococcal disease in infants aged younger than 3 months: Systematic review and meta-analysis. Lancet. 2012;379(9815):547–56. https://doi.org/10.1016/s0140-6736(11)61651-6.

Dangor Z, Lala SG, Cutland CL, Koen A, Jose L, Nakwa F, et al. Burden of invasive group B Streptococcus disease and early neurological sequelae in South African infants. PLoS One. 2015;10(4):1–13. https://doi.org/10.1371/journal.pone.0123014.

Paul P, Chandna J, Procter SR, Dangor Z, Leahy S, Santhanam S, et al. Neurodevelopmental and growth outcomes after invasive Group B Streptococcus in early infancy: A multi-country matched cohort study in South Africa, Mozambique, India, Kenya, and Argentina. Lancet eClinicalMedicine. 2022;47:101358. https://doi.org/10.1016/j.eclinm.2022.101358.

Woldesenbet, S.A., Lombard, C., Manda, et al. The 2019 National Antenatal HIV Sentinel Survey (ANCHSS), South Africa, National Department of Health. 2021. Available from: https://www.nicd.ac.za/wp-content/uploads/2021/11/Antenatal-survey-2019-report_FINAL_27April21.pdf

Dangor Z, Lala SG, Madhi SA. Preventing invasive Group B Streptococcus (GBS) disease in South African infants: Time for change. SAJCH South African J Child Heal. 2015;9(3):69–70. https://doi.org/10.7196/sajch.8575.

Irene A Stafford, Eliza Rodrigue, Alexandra Berra, Asha J. The Strong Correlation between neonatal early-onset Group B Streptococcal disease and necrotizing enterocolitis. Obs Gynecol Reprod Biol. 2018;223:93–7. https://doi.org/10.1016/j.ejogrb.2018.02.024.

Hofer N, Müller W. An Update on the Use of C-Reactive Protein in Early-Onset Neonatal Sepsis : Neonatology. 2012;102:25–36. https://doi.org/10.1159/000336629.

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