Dutch Guidelines Do Not Cut Incidence of Group B Strep in Newborns
(HealthDay News) — Dutch guidelines, implemented in 1999, do not appear to be effective for reducing the incidence of invasive group B streptococcal disease in newborns, according to a study published in the November issue of The Lancet Infectious Diseases.
Vincent Bekker, PhD, from Emma Children's Hospital in Amsterdam, and colleagues conducted a nationwide surveillance study using data from the Netherlands Reference Laboratory for Bacterial Meningitis for 1987–2011. They compared the incidence and distribution of clonal complexes before and after Dutch guideline introduction (intravenous antibiotic prophylaxis during labor in cases of premature labor, prolonged rupture of membranes, or fever during delivery).
The researchers found that 65% of group B streptococcus cases had early onset (<7 days after birth). In 1987, the incidence of invasive group B streptococcus infection was 0.2 per 1,000 live births, and it increased to 0.32 per 1,000 live births in 2011 (P<0.0001). There was also an increase seen in the incidence of early-onset disease (0.11–0.19 per 1,000 live births; P<0.0001). There was a trend toward increased incidence of invasive Escherichia coli infection (0.05 in 1987 to 0.16 in 2011; P=0.17). In the post-implementation vs. the pre-implementation period, early-onset group B streptococcus infection caused by isolates belonging to clonal complex 17 was more common (P=0.002).
"The guidelines should be reassessed and alternative approaches to prevent infant invasive group B streptococcus disease should be sought," the authors write.