Screening-based and Risk-based Strategy for the Prevention of Early-onset Group B Streptococcus/Non-group B Streptococcus Sepsis in the Neonate: A Systematic Review and Meta-analysis
| Autor: | Hong-Tian Li, Qiu-Ya Li, Jian-Meng Liu, Ding-Yuan Wang |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Microbiology (medical)
medicine.medical_specialty Risk Assessment Streptococcus agalactiae law.invention Sepsis 03 medical and health sciences 0302 clinical medicine Randomized controlled trial Pregnancy law Streptococcal Infections 030225 pediatrics Internal medicine Humans Mass Screening Medicine 030212 general & internal medicine Pregnancy Complications Infectious business.industry Incidence Incidence (epidemiology) Antibiotic Prophylaxis medicine.disease Confidence interval Study heterogeneity Infectious Diseases Meta-analysis Relative risk Pediatrics Perinatology and Child Health Female Neonatal Sepsis business Cohort study |
| Zdroj: | Pediatric Infectious Disease Journal. 39:740-748 |
| ISSN: | 0891-3668 |
| DOI: | 10.1097/inf.0000000000002674 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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