Global assessment of non-invasive group B streptococcal disease incidence: systematic review and meta-analysis
Author(s): ,
Simon Collin
Affiliations:
PHE
,
Rebecca Guy
Affiliations:
PHE
,
Nandini Shetty
Affiliations:
PHE
Theresa Lamagni
Affiliations:
PHE
PHE ePoster Library. Collin S. 03/20/18; 205897; 12526
Dr. Simon Collin
Dr. Simon Collin
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Abstract
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Abstract Background: The epidemiology of group B Streptococcus (GBS; Streptococcus agalactiae) as a cause of non-invasive disease is poorly characterised. Our aim was to identify worldwide estimates of non-invasive GBS disease incidence, including surgical site infection (SSI), urinary tract infection (UTI) and catheter-associated UTI (CAUTI), by systematic review and meta-analysis.Methods: We defined non-invasive GBS infections by exclusion of GBS detected in sterile sites. SSI included superficial, deep and organ/space infections. Our primary outcome was GBS as proportion of culture-positive isolates. We searched MEDLINE, EMBASE, CINAHL, Scopus, Global Health, and Trip without language restriction, and contacted institutions with potentially relevant raw data. Heterogeneity was explored by age, sex, geography, and microbiological method. PROSPERO reg. CRD42017068914.Results: We identified 10,879 references, comprising 3609 from MEDLINE, 4808 from EMBASE, 101 from CINAHL, 661 from Scopus, 417 from Global Health, and 1283 from Trip. De-duplication removed 3690 references, leaving 7189 for screening by title and abstract, distilled to 263 for full text review. Of these, 104 described SSI, 119 UTI (of which 37 were nosocomial), and 74 described other infections. Preliminary meta-analyses including data from PHE, ECDC, CDC and VICNISS (Australia) showed that the proportion of SSI isolates positive for GBS by type of surgery was: 3.03% (95% CI 1.70-4.70%) for obstetrical/gynaecological; 2.15% (1.56-2.83%) for vascular; 0.71% (0.18-1.48%) for orthopaedic; 1.40% (0.78-2.18%) for breast; 0.11% (0.00-0.31%) for abdominal; and 0.07% (0.00-0.44%) for cardiac. The proportions of community UTI, hospital UTI and CAUTI isolates positive for GBS were 1.69% (1.67-1.71%), 1.78% (1.75-1.81%) and 0.18% (0.00-0.57%), respectively.Conclusion: Meta-analysis will provide estimates for the proportions of surgical site, urinary tract (community and hospital-acquired) and other non-invasive infections for which GBS was implicated as a causal pathogen, findings of importance in considering target groups for future vaccination. Funding This study was funded by a grant from Pfizer Inc.
Abstract Background: The epidemiology of group B Streptococcus (GBS; Streptococcus agalactiae) as a cause of non-invasive disease is poorly characterised. Our aim was to identify worldwide estimates of non-invasive GBS disease incidence, including surgical site infection (SSI), urinary tract infection (UTI) and catheter-associated UTI (CAUTI), by systematic review and meta-analysis.Methods: We defined non-invasive GBS infections by exclusion of GBS detected in sterile sites. SSI included superficial, deep and organ/space infections. Our primary outcome was GBS as proportion of culture-positive isolates. We searched MEDLINE, EMBASE, CINAHL, Scopus, Global Health, and Trip without language restriction, and contacted institutions with potentially relevant raw data. Heterogeneity was explored by age, sex, geography, and microbiological method. PROSPERO reg. CRD42017068914.Results: We identified 10,879 references, comprising 3609 from MEDLINE, 4808 from EMBASE, 101 from CINAHL, 661 from Scopus, 417 from Global Health, and 1283 from Trip. De-duplication removed 3690 references, leaving 7189 for screening by title and abstract, distilled to 263 for full text review. Of these, 104 described SSI, 119 UTI (of which 37 were nosocomial), and 74 described other infections. Preliminary meta-analyses including data from PHE, ECDC, CDC and VICNISS (Australia) showed that the proportion of SSI isolates positive for GBS by type of surgery was: 3.03% (95% CI 1.70-4.70%) for obstetrical/gynaecological; 2.15% (1.56-2.83%) for vascular; 0.71% (0.18-1.48%) for orthopaedic; 1.40% (0.78-2.18%) for breast; 0.11% (0.00-0.31%) for abdominal; and 0.07% (0.00-0.44%) for cardiac. The proportions of community UTI, hospital UTI and CAUTI isolates positive for GBS were 1.69% (1.67-1.71%), 1.78% (1.75-1.81%) and 0.18% (0.00-0.57%), respectively.Conclusion: Meta-analysis will provide estimates for the proportions of surgical site, urinary tract (community and hospital-acquired) and other non-invasive infections for which GBS was implicated as a causal pathogen, findings of importance in considering target groups for future vaccination. Funding This study was funded by a grant from Pfizer Inc.
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