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Neonatal Group B Streptococcal Infection in a Tertiary Care Hospital in Saudi Arabia

A 13-year Experience

Al Luhidan, Lama MD*; Madani, Areej MD*; Albanyan, Esam A. MD; Al Saif, Saif MD; Nasef, Minosh MD; AlJohani, Sameera MD; Madkhali, Azzah MD§; Al Shaalan, Mohammed MD; Alalola, Sulaiman MD

The Pediatric Infectious Disease Journal: July 2019 - Volume 38 - Issue 7 - p 731–734
doi: 10.1097/INF.0000000000002269
Maternal-Neonatal Reports
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Background: Group B streptococcus (GBS) is a leading cause of neonatal bacterial sepsis and meningitis globally. Studies concerning the incidence and burden of neonatal GBS disease in Saudi Arabia are lacking. This study determined the incidence and burden of GBS infection among neonates in association with maternal GBS screening.

Methods: A retrospective cohort chart review study included all neonatal GBS disease cases identified through microbiology lab records within the first 90 days of life in the hospital from January 2004 to December 2016. Charts were reviewed to collect maternal and neonatal characteristics using a standardized form.

Results: Over 13 years, of 108,609 live births, 55 GBS disease cases were identified (overall incidence, 0.51/1000 live births), 69.1% (n = 38) of those had early onset disease (EOD). The annual incidence in 2015 and 2016 was significantly higher than in any previous year (P < 0.0001), coinciding with the discontinuation of routine universal maternal GBS screening. Median age at presentation was 1 day (range, 0–54 days). We found that 67.3% (n = 37) of mothers were not screened antenatally, 72.9% (n = 27) of whom had neonates present with EOD. Neonates of unscreened mothers were more likely to have GBS disease (P = 0.01) and to present with EOD (P = 0.005). Urinary tract infection was the most common manifestation (47.3%, n = 26), followed by sepsis (43.6%, n = 24). Mortality rate was 3.6% (n = 2).

Conclusions: The incidence of neonatal GBS infection in Saudi Arabia is similar to the worldwide incidence. Universal antenatal screening discontinuation was significantly associated with an increase in EOD incidence.

From the *King Saud bin Abdulaziz University for Health Sciences, College of Medicine, Riyadh, Saudi Arabia

Section of Pediatric Infectious Diseases, Department of Pediatrics, King Abdullah Specialist Children Hospital, Riyadh, Saudi Arabia

Section of Neonatology, Department of Pediatrics

§Division of Microbiology, Pathology and Laboratory Medicine

Department of Obstetrics and Gynecology, King Abdulaziz Medical City, NGHA, Riyadh, Saudi Arabia.

Accepted for publication December 7, 2018.

The authors have no funding or conflicts of interest to disclose.

Address to correspondence: Sulaiman Alalola, MD, King Saud bin Abdulaziz University for Health Sciences, Consultant, Pediatric Infectious Diseases, King Abdullah Specialized Children Hospital, Riyadh, Saudi Arabia. E-mail: Salola07@gmail.com; alolas@ngha.med.sa.

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