Hospital clusters of invasive Group B Streptococcal disease: A systematic review

Simon M Collin, Peter Lamb, Elita Jauneikaite, Kirsty Le Doare, Roberta Creti, Alberto Berardi, Paul T Heath, Shiranee Sriskandan, Theresa Lamagni

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Abstract

OBJECTIVES: To characterize outbreaks of invasive Group B Streptococcal (iGBS) disease in hospitals.

METHODS: Systematic review using electronic databases to identify studies describing iGBS outbreaks/clusters or cross-infection/acquisition in healthcare settings where 'cluster' was defined as ≥2 linked cases. PROSPERO CRD42018096297.

RESULTS: Twenty-five references were included describing 30 hospital clusters (26 neonatal, 4 adult) in 11 countries from 1966 to 2019. Cross-infection between unrelated neonates was reported in 19 clusters involving an early-onset (<7 days of life; n = 3), late-onset (7-90 days; n = 13) index case or colonized infant (n = 3) followed by one or more late-onset cases (median serial interval 9 days (IQR 3-17, range 0-50 days, n = 45)); linkage was determined by phage typing in 3 clusters, PFGE/MLST/PCR in 8, WGS in 4, non-molecular methods in 4. Postulated routes of transmission in neonatal clusters were via clinical personnel and equipment, particularly during periods of crowding and high patient-to-nurse ratio. Of 4 adult clusters, one was attributed to droplet spread between respiratory cases, one to handling of haemodialysis catheters and two unspecified.

CONCLUSIONS: Long intervals between cases were identified in most of the clusters, a characteristic which potentially hinders detection of GBS hospital outbreaks without enhanced surveillance supported by genomics.

Original languageEnglish
Pages (from-to)521-527
Number of pages7
JournalJournal of Infection
Volume79
Issue number6
Early online date13 Nov 2019
DOIs
Publication statusPublished - Dec 2019

Bibliographical note

Copyright © 2019. Published by Elsevier Ltd.

Keywords

  • Streptococcus agalactiae
  • Group B streptococcal disease
  • Adult
  • Neonatal
  • Outbreak
  • Cluster
  • Healthcare-associated infection
  • Systematic review

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