Group B Streptococcus Infection in Extremely Preterm Neonates and Neurodevelopmental Outcomes at 2 Years
Year: 2022
Type: article
Study design: Observational Study
Abstract: BACKGROUND: This study was performed to determine the incidence of group B Streptococcus (GBS) disease among extremely preterm infants and assess to risk of death or neurodevelopmental impairment (NDI) at a corrected age of 18-26 months. METHODS: In this observational cohort study of infants enrolled in a multicenter registry, the incidence of GBS disease was assessed in infants born in 1998-2016 at 22-28 weeks' gestation and surviving for >12 hours. The composite outcome, death or NDI, was assessed in infants born in 1998-2014 at 22-26 weeks' gestation. Infection was defined as GBS isolation in blood or cerebrospinal fluid culture at ≤72 hours (early-onset disease [EOD]) or >72 hours (late-onset disease [LOD]) after birth. Using Poisson regression models, the outcome was compared in infants with GBS disease, infants infected with other pathogens, and uninfected infants. RESULTS: The incidence of GBS EOD (2.70/1000 births [95% confidence interval (CI), 2.15-3.36]) and LOD (8.47/1000 infants [7.45-9.59]) did not change significantly over time. The adjusted relative risk of death/NDI was higher among infants with GBS EOD than in those with other infections (adjusted relative risk, 1.22 [95% CI, 1.02-1.45]) and uninfected infants (1.44 [1.23-1.69]). Risk of death/NDI did not differ between infants with GBS LOD and comparator groups. GBS LOD occurred at a significantly later age than non-GBS late-onset infection. Among infants surviving >30 days, the risk of death was higher with GBS LOD (adjusted relative risk, 1.90 [95% CI, 1.36-2.67]), compared with uninfected infants. CONCLUSIONS: In a cohort of extremely preterm infants, the incidence of GBS disease did not change during the study period. The increased risk of death or NDI with GBS EOD, and of death among some infants with GBS LOD, supports the need for novel preventive strategies for disease reduction. CLINICAL TRIALS REGISTRATION: NCT00063063.
Source: Clinical Infectious Diseases
DOI: 10.1093/cid/ciac222
Institutions: Children's Hospital of Philadelphia, University of Pennsylvania, RTI International, Duke University, Nationwide Children's Hospital, The Ohio State University, University of Iowa, The University of Texas Southwestern Medical Center, The University of Texas Health Science Center at Houston
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: green
Awards: Stanford Center for Clinical and Translational Education and Research (SCCTER)UL1, G1186807586, University of New Mexico Clinical and Translational Science Center, Rochester-Buffalo Neonatal Research Group, NICHD Cooperative Multicenter Neonatal Research Network, Duke CTSA (Composite), Multicenter Network of Neonatal Intensive Care Units, NICHD Neonatal Research Network (NRN), NICHD Cooperative Multicenter Neonatal Research Network, Cooperative Multicenter Neonatal Research Network, One Center, Two States, Cooperative Multicenter Network of Neonatal Intensive Care Units, NICHD Cooperative Multicenter Neonatal Research Network, Multicenter Network of Neonatal Intensive Care Units, Neonatal Research Network Data Coordinating Center (DCC), Atlanta Clinical and Translational Science Institute (ACTSI) Renewal, The University of Rochester's Clinical and Translational Science Institute, Eunice Kennedy Shriver NICHD Cooperative Multicenter Neonatal Research Network, Indiana Clinical and Translational Science Institute (UL1), University of Iowa Clinical and Translational Science Program, NICHD Neonatal Research Network, Yale University Clinical and Translational Science Award Program, Multicenter Network of Neonatal Intensive Care Units-University of Texas at Houston (UT Houston) Clinical Center, Incidence of atopy and childhood infections in uninfected term newborns with perinatal antibiotic exposure, Cincinnati Center for Clinical and Translational Sciences and Training, University of Utah Center for Clinical and Translational Science-UL1, Data Ctr for the Cooperative Neonatal Research Network, NICHD Coooperative Multicenter Neonatal Research Network, NICHD Neonatal Research Network Clinical Center UAB, NICHD Cooperative Multicenter Neonatal Research Network - Utah Center, NICHD Neonatal Research Network -- Cincinnati Clinical Center, NICHD Neonatal Research Network - Stanford University, NICHD Neonatal Research Network Clinical Center - Case Western Reserve University, NICHD Neonatal Research Network, Eunice Kennedy Shriver NICHD Cooperative Multicenter Neonatal ResearchNetwork, Clinical Center for NICHD/Neonatal Research Network, NICHD COPPERATIVE MULTICENTER NEONATAL RESEARCH NETWORK, NICHD Cooperative Multicenter Neonatal Research Network, North Carolina Clinical Center
OpenAlex ID: W4220847142