This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in JAMA  Topic Collections  • Drug Therapy, Other  • Bacterial Infections  • Neurology  • Pregnancy and Breast Feeding  • Pediatrics  • Neonatology and Infant Care  • Alert me on articles by topic

Christina R. Phares, PhD; Ruth Lynfield, MD; Monica M. Farley, MD; Janet Mohle-Boetani, MD; Lee H. Harrison, MD; Susan Petit, MPH; Allen S. Craig, MD; William Schaffner, MD; Shelley M. Zansky, PhD; Ken Gershman, MD; Karen R. Stefonek, MPH; Bernadette A. Albanese, MD; Elizabeth R. Zell, MStat; Anne Schuchat, MD; Stephanie J. Schrag, DPhil

JAMA. 2008;299(17):2056-2065.

Context  Group B streptococcus is a leading infectious cause of morbidity in newborns and causes substantial disease in elderly individuals. Guidelines for prevention of perinatal disease through intrapartum chemoprophylaxis were revised in 2002. Candidate vaccines are under development.

Objective  To describe disease trends among populations that might benefit from vaccination and among newborns during a period of evolving prevention strategies.

Design and Setting  Analysis of active, population-based surveillance in 10 states participating in the Active Bacterial Core surveillance/Emerging Infections Program Network.

Main Outcome Measures  Age- and race-specific incidence of invasive group B streptococcal disease.

Results  There were 14 573 cases of invasive group B streptococcal disease during 1999-2005, including 1348 deaths. The incidence of invasive group B streptococcal disease among infants from birth through 6 days decreased from 0.47 per 1000 live births in 1999-2001 to 0.34 per 1000 live births in 2003-2005 (P < .001), a relative reduction of 27% (95% confidence interval [CI], 16%-37%). Incidence remained stable among infants aged 7 through 89 days (mean, 0.34 per 1000 live births) and pregnant women (mean, 0.12 per 1000 live births). Among persons aged 15 through 64 years, disease incidence increased from 3.4 per 100 000 population in 1999 to 5.0 per 100 000 in 2005 (²₁ for trend, 57; P < .001), a relative increase of 48% (95% CI, 32%-65%). Among adults 65 years or older, incidence increased from 21.5 per 100 000 to 26.0 per 100 000 (²₁ for trend, 15; P < .001), a relative increase of 20% (95% CI, 8%-35%). All 4882 isolates tested were susceptible to penicillin, ampicillin, and vancomycin, but 32% and 15% were resistant to erythromycin and clindamycin, respectively. Serotypes Ia, Ib, II, III, and V accounted for 96% of neonatal cases and 88% of adult cases.

Conclusions  Among infants from birth through 6 days, the incidence of group B streptococcal disease was lower in 2003-2005 relative to 1999-2001. This reduction coincided with the release of revised disease prevention guidelines in 2002. However, the disease burden in adults is substantial and increased significantly during the study period.

Author Affiliations: Epidemic Intelligence Service Program, Office of Workforce and Career Development (Dr Phares) and Respiratory Diseases Branch (Drs Phares, Schuchat, and Schrag) and Biostatistics and Information Management Branch (Ms Zell), Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Minnesota Department of Health, St Paul (Dr Lynfield); Emory University School of Medicine and Atlanta VA Medical Center, Georgia Emerging Infections Program, Atlanta, Georgia (Dr Farley); Infectious Diseases Branch, California Department of Health Services, Richmond (Dr Mohle-Boetani); Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland (Dr Harrison); Emerging Infections Program, Connecticut Department of Public Health, Hartford (Ms Petit); Tennessee Department of Health, Nashville (Dr Craig); Department of Preventive Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee (Dr Schaffner); New York State Department of Health, Albany (Dr Zansky); Colorado Department of Public Health and Environment, Denver (Dr Gershman); Oregon Public Health Services, Portland (Ms Stefonek); and New Mexico Department of Health Emerging Infections Program, Santa Fe (Dr Albanese).

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Group B Strep in the U.S.
JWatch Infect. Diseases 2008;2008:1-1.
FULL TEXT