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Title: Serotype distribution and incidence of invasive early onset and late onset group B streptococcal disease amongst infants in Singapore
Authors: Kam, Kai-Qian
Thoon, Koh Cheng
Tee, Nancy Wen Sim
Ang, Michelle Lay Teng
Tan, Natalie Woon Hui
Yeo, Kee Thai
Li, Jiahui
Chong, Chia Yin
Keywords: Science::Medicine
Issue Date: 2021
Source: Kam, K., Thoon, K. C., Tee, N. W. S., Ang, M. L. T., Tan, N. W. H., Yeo, K. T., Li, J. & Chong, C. Y. (2021). Serotype distribution and incidence of invasive early onset and late onset group B streptococcal disease amongst infants in Singapore. BMC Infectious Diseases, 21(1), 1221-.
Journal: BMC Infectious Diseases 
Abstract: Background: The current group B streptococcal (GBS) preventive measures had reduced invasive GBS early onset disease (EOD) incidences worldwide, but the late onset disease (LOD) incidences had remained unchanged. Administration of a safe and effective GBS vaccine in addition to the current strategies were thought to be the next steps in reducing the incidences of invasive GBS infection especially LOD. In this study, we aimed to examine the causative GBS serotypes in invasive GBS disease, determine the incidences of EOD and LOD, and compare the risk factors between EOD and LOD. Methods: A retrospective study of infants ≤90-day-old over an 8-year period (2010–2017). The incidences of EOD and LOD were obtained by using patients with EOD and LOD who were born in our institution as the numerator and the live births in our institution per year of the study period as the denominator. Available GBS isolates were serotyped by the National Public Health Laboratory using capsular serotyping methods. The risk factors of EOD and LOD were compared. Results: A total of 71 infants were identified; 16 (22.5%) and 55 (77.5%) of them had EOD and LOD, respectively. Serotype III (n=42, 71.2%) was the most common serotype amongst the 59 isolates available for serotyping. Serotypes Ia, Ib, II, III, and V accounted for 98.3% (n=58) of the invasive GBS diseases. The overall incidence was 0.42 per 1000 live births. The mean incidences of EOD and LOD were 0.13 per 1000 live births and 0.29 per 1000 live births, respectively. On multivariate analysis, risk factors for LOD as compared to EOD were: Chinese ethnicity (OR 27.1, 95% CI 3.0–243.1, p=0.003) and negative/unknown maternal GBS status (OR 20.0, 95% CI 2.0–250.0, p=0.012). Prematurity and intra partum risk factors (peripartum maternal pyrexia, prolonged rupture of membrane) of EOD were not associated with LOD. Conclusions: The LOD incidence had remained higher than EOD incidence in our cohort. A GBS vaccine that covers the major causative serotypes found in our cohort can potentially reduce the overall GBS disease burden in the country.
ISSN: 1471-2334
DOI: 10.1186/s12879-021-06891-1
Schools: Lee Kong Chian School of Medicine (LKCMedicine) 
Organisations: KK Women’s and Children’s Hospital
Yong Loo Lin School of Medicine, National University of Singapore
Duke-National University of Singapore Medical School
Rights: © The Author(s) 2021. Open Access. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit The Creative Commons Public Domain Dedication waiver (http://creativeco applies to the data made available in this article, unless otherwise stated in a credit line to the data.
Fulltext Permission: open
Fulltext Availability: With Fulltext
Appears in Collections:LKCMedicine Journal Articles

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