Maternal Colonization With Group B Streptococcus and Serotype Distribution Worldwide: Systematic Review and Meta-analyses

被引:331
作者
Russell, Neal J. [1 ,2 ]
Seale, Anna C. [1 ,3 ]
O'Driscoll, Megan [4 ]
O'Sullivan, Catherine [5 ]
Bianchi-Jassir, Fiorella [1 ]
Gonzalez-Guarin, Juan [6 ]
Lawn, Joy E. [1 ]
Baker, Carol J. [7 ,8 ,9 ]
Bartlett, Linda [10 ]
Cutland, Clare [11 ,12 ]
Gravett, Michael G. [13 ,14 ]
Heath, Paul T.
Le Doare, Kirsty [4 ,5 ]
Madhi, Shabir A. [11 ,12 ,15 ]
Rubens, Craig E. [13 ,16 ]
Schrag, Stephanie [17 ]
Sobanjo-ter Meulen, Ajoke [18 ]
Vekemans, Johan [19 ]
Saha, Samir K. [20 ]
Ip, Margaret [21 ]
机构
[1] London Sch Hyg & Trop Med, Maternal Adolescent Reprod & Child Hlth Ctr, Keppel St, London WC1E 7HT, England
[2] Kings Coll London, London, England
[3] Haramaya Univ, Coll Hlth & Med Sci, Dire Dawa, Ethiopia
[4] Imperial Coll London, Ctr Int Child Hlth, London, England
[5] St Georges Univ London, Paediat Infect Dis Res Grp, London, England
[6] Hosp Clin Corpas, Bogota, Colombia
[7] Baylor Coll Med, Dept Pediat, Houston, TX 77030 USA
[8] Baylor Coll Med, Dept Mol Virol, Houston, TX 77030 USA
[9] Baylor Coll Med, Dept Microbiol, Houston, TX 77030 USA
[10] Johns Hopkins Bloomberg Sch Publ Hlth, Dept Int Hlth, Baltimore, MD USA
[11] Univ Witwatersrand, Fac Hlth Sci, MRC, Resp & Meningeal Pathogens Res Unit, Johannesburg, South Africa
[12] Univ Witwatersrand, Fac Hlth Sci, Natl Res Fdn Vaccine Preventable Dis, Dept Sci & Technol, Johannesburg, South Africa
[13] Univ Washington, Global Alliance Prevent Prematur & Stillbirth, Seattle, WA 98195 USA
[14] Univ Washington, Dept Obstet & Gynecol, Seattle, WA 98195 USA
[15] Natl Hlth Lab Serv, Natl Inst Communicable Dis, Johannesburg, South Africa
[16] Univ Washington, Dept Global Hlth, Seattle, WA 98195 USA
[17] Ctr Dis Control & Prevent, Natl Ctr Immunizat & Resp Dis, Atlanta, GA USA
[18] Bill & Melinda Gates Fdn, Seattle, WA USA
[19] WHO, Geneva, Switzerland
[20] Inst Child Hlth, Dhaka, Bangladesh
[21] Chinese Univ Hong Kong, Fac Med, Dept Microbiol, Hong Kong, Hong Kong, Peoples R China
基金
比尔及梅琳达.盖茨基金会;
关键词
group B Streptococcus; colonization; vaginal; pregnancy; serotypes; PREGNANT-WOMEN; DISEASE WORLDWIDE; RISK-FACTORS; POPULATION-STRUCTURE; AGALACTIAE; CARRIAGE; PREVALENCE; EPIDEMIOLOGY; STILLBIRTHS; ACCURACY;
D O I
10.1093/cid/cix658
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Background. Maternal rectovaginal colonization with group B Streptococcus (GBS) is the most common pathway for GBS disease in mother, fetus, and newborn. This article, the second in a series estimating the burden of GBS, aims to determine the prevalence and serotype distribution of GBS colonizing pregnant women worldwide. Methods. We conducted systematic literature reviews (PubMed/Medline, Embase, Latin American and Caribbean Health Sciences Literature [LILACS], World Health Organization Library Information System [WHOLIS], and Scopus), organized Chinese language searches, and sought unpublished data from investigator groups. We applied broad inclusion criteria to maximize data inputs, particularly from low-and middle-income contexts, and then applied new meta-analyses to adjust for studies with less-sensitive sampling and laboratory techniques. We undertook meta-analyses to derive pooled estimates of maternal GBS colonization prevalence at national and regional levels. Results. The dataset regarding colonization included 390 articles, 85 countries, and a total of 299 924 pregnant women. Our adjusted estimate for maternal GBS colonization worldwide was 18% (95% confidence interval [CI], 17%-19%), with regional variation (11%-35%), and lower prevalence in Southern Asia (12.5% [95% CI, 10%-15%]) and Eastern Asia (11% [95% CI, 10%-12%]). Bacterial serotypes I-V account for 98% of identified colonizing GBS isolates worldwide. Serotype III, associated with invasive disease, accounts for 25% (95% CI, 23%-28%), but is less frequent in some South American and Asian countries. Serotypes VI-IX are more common in Asia. Conclusions. GBS colonizes pregnant women worldwide, but prevalence and serotype distribution vary, even after adjusting for laboratory methods. Lower GBS maternal colonization prevalence, with less serotype III, may help to explain lower GBS disease incidence in regions such as Asia. High prevalence worldwide, and more serotype data, are relevant to prevention efforts.
引用
收藏
页码:S100 / S111
页数:12
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