Publisher Information: Umeå universitet, Pediatrik New Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland New Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden; Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden Department of Intensive Care for Newborns and Infants, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark Neisseria and Streptococcus Reference Laboratory, Department of Bacteria, Statens Serum Institut, Copenhagen, Denmark University of Iceland, Faculty of Medicine, Reykjavik, Iceland; Children's Hospital Iceland, Landspitali University Hospital, Reykjavik, Iceland University of Iceland, Faculty of Medicine, Reykjavik, Iceland; Children's Hospital Iceland, Landspitali University Hospital, Reykjavik, Iceland Department of Neonatal Intensive Care, Clinic of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Children's Clinic, St. Olavs University Hospital, Trondheim, Norway Research Service Unit, Oulu University Hospital, Oulu, Finland; Department of Paediatrics and Adolescent Medicine, Oulu University Hospital, Oulu, Finland Research Service Unit, Oulu University Hospital, Oulu, Finland; Department of Paediatrics and Adolescent Medicine, Oulu University Hospital, Oulu, Finland Department of Paediatrics and Adolescent Medicine, Oulu University Hospital, Oulu, Finland; Biocenter Oulu and Research Unit of Clinical Medicine, University of Oulu, Oulu, Finland European Centre for Disease Control and Prevention (ECDC) 2024
نبذة مختصرة : Background: Neonatal early-onset disease caused by group B Streptococcus (GBS) is a leading cause of infant morbidity. Intrapartum antibiotic prophylaxis (IAP) is effective in preventing early-onset GBS disease, but there is no agreement on the optimal strategy for identifying the pregnant women requiring this treatment, and both risk-based prophylaxis (RBP) and GBS screening-based prophylaxis (SBP) are used. Aim: The aim of this study was to evaluate the effect of SBP as a public health intervention on the epidemiology of early-onset GBS infections. Methods: In 2012, Finland started the universal SBP, while Denmark, Iceland, Norway and Sweden continued with RBP. We conducted an interrupted time series analysis taking 2012 as the intervention point to evaluate the impact of this intervention. The incidences of early- and late-onset GBS infections during Period I (1995-2011) and Period II (2012-2019) were collected from each national register, covering 6,605,564 live births. Results: In Finland, a reduction of 58% in the incidence of early-onset GBS disease, corresponding to an incidence rate ratio (IRR) of 0.42 (95% CI: 0.34-0.52), was observed after 2012. At the same time, the pooled IRR of other Nordic countries was 0.89 (95% CI: 0.80-1.0), specifically 0.89 (95% CI: 0.70-1.5) in Denmark, 0.34 (95% CI: 0.15-0.81) in Iceland, 0.72 (95% CI: 0.59-0.88) in Norway and 0.97 (95% CI: 0.85-1.1) in Sweden. Conclusions: In this ecological study of five Nordic countries, early-onset GBS infections were approximately halved following introduction of the SBP approach as compared with RBP.
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