AI Article Synopsis
- The study compares screening-based and risk-based strategies for preventing early-onset group B streptococcus (GBS) sepsis in newborns, aiming to determine which is more effective in reducing incidence rates.
- An analysis of 18 cohort studies involving over 604,000 newborns showed that the screening-based strategy reduced the risk of GBS-EOS by 55% compared to the risk-based strategy.
- The impact on non-GBS sepsis was less clear, with a slight decrease in risk for total early-onset non-GBS sepsis but an increased risk noted for a specific subgroup of antibiotic-resistant E. coli infections with the screening approach.
Article Abstract
Background: Screening-based and risk-based strategies are the 2 strategies for preventing group B streptococcus (GBS) diseases in neonates. We aimed to compare the effects of these 2 strategies in reducing the incidence of early-onset GBS sepsis (GBS-EOS) and their effects on the incidence of non-GBS sepsis.
Methods: PubMed, Embase, Web of Science and The Cochrane Central Register of Controlled Trials were searched for the period from January 1, 1996, to December 31, 2018. Randomized controlled trials and cohort studies that compared the effects of risk-based and screening-based strategies were eligible for the meta-analysis. The I statistic was used for assessing the statistical heterogeneity across studies. Pooled relative risks (RRs) and corresponding 95% confidence intervals (CIs) were calculated using the random effects model.
Results: There were 18 cohort studies comparing the incidence of GBS-EOS between the 2 strategies, involving a total of 604,869 newborns and 791 GBS-EOS cases. The heterogeneity across studies was moderate (I = 45%), and the pooled analysis yielded a 55% decreased risk of GBS-EOS for screening-based versus risk-based strategy (RR = 0.45; 95% CI: 0.34-0.59). For total early onset non-GBS sepsis (non-GBS-EOS), 7 studies with low heterogeneity (I = 18%) had a pooled RR of 0.91 (95% CI: 0.74-1.11), whereas for ampicillin resistant Escherichia coli-EOS, a subgroup of non-GBS-EOS, 3 studies with very low heterogeneity (I = 0%) had a pooled RR of 1.28 (95% CI: 0.74-2.21) for screening-based strategy compared with risk-based strategy.
Conclusions: Compared with risk-based strategy, screening-based prophylaxis was associated with a reduced risk of GBS-EOS.
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| http://dx.doi.org/10.1097/INF.0000000000002674 | DOI Listing |
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