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

Collin, SM; Lamb, P; Jauneikaite, E; Le Doare, K; Creti, R; Berardi, A; Heath, PT; Sriskandan, S; Lamagni, T (2019) Hospital clusters of invasive Group B Streptococcal disease: A systematic review. J Infect, 79 (6). pp. 521-527. ISSN 1532-2742 https://doi.org/10.1016/j.jinf.2019.11.008
SGUL Authors: Heath, Paul Trafford Le Doare, Kirsty

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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.

Item Type: Article
Additional Information: © 2019 The Authors. Published by Elsevier Ltd on behalf of The British Infection Association. This is an open access article under the CC BY-NC-ND license. (http://creativecommons.org/licenses/by-nc-nd/4.0/)
Keywords: Adult, Cluster, Group B streptococcal disease, Healthcare-associated infection, Neonatal, Outbreak, Streptococcus agalactiae, Systematic review, Adult, Cluster, Group B streptococcal disease, Healthcare-associated infection, Neonatal, Outbreak, Streptococcus agalactiae, Systematic review, Microbiology, 1103 Clinical Sciences
SGUL Research Institute / Research Centre: Academic Structure > Infection and Immunity Research Institute (INII)
Journal or Publication Title: J Infect
ISSN: 1532-2742
Language: eng
Dates:
DateEvent
December 2019Published
13 November 2019Published Online
8 November 2019Accepted
Publisher License: Creative Commons: Attribution-Noncommercial-No Derivative Works 4.0
PubMed ID: 31733233
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/111420
Publisher's version: https://doi.org/10.1016/j.jinf.2019.11.008

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