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Volume 25, Number 11—November 2019
Research

Clinical and Molecular Epidemiology of Invasive Group B Streptococcus Disease among Infants, China

Wenjing Ji , Haiying LiuComments to Author , Shabir A. Madhi, Marianne Cunnington, Zilu Zhang, Ziyaad Dangor, Haijian Zhou, Xiaoping Mu, Zhengjiang Jin, Aimin Wang, Xiaosong Qin, Chunyan Gao, Yuning Zhu, Xiaodan Feng, Shangyang She, Shuhua Yang, Jing Liu, Jine Lei, Lan Jiang, Zeshi Liu, Gang Li, Qiuhong Li, Qiulian Deng, Kankan Gao, and Yu Fang Comments to Author 
Author affiliations: Xi’an Jiaotong University, Xi’an, China (W. Ji, Y. Fang); Guangzhou Medical University, Guangzhou, China (H. Liu, Q. Deng, K. Gao); University of the Witwatersrand, Johannesburg, South Africa (S.A. Madhi, Z. Dangor); GlaxoSmithKline Plc, London, UK (M. Cunnington); Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA (Z. Zhang); Chinese Center for Disease Control and Prevention, Beijing, China (H. Zhou); Guangzhou Medical University, Guangzhou (X. Mu); Hubei Maternal and Child Health Hospital, Wuhan, China (Z. Jin); Children’s Hospital of Fudan University, Shanghai, China (A. Wang); China Medical University, Shenyang, China (X. Qin); Tangshan Maternal and Child Health Care Hospital, Tangshan, China (C. Gao); Zhejiang University, Hangzhou, China (Y. Zhu); Nanjing Maternity and Child Health Care Hospital, Nanjing, China (X. Feng); Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanjing (S. She); Tianjin Central Hospital of Gynecology Obstetrics, Tianjin, China (S. Yang); Tsinghua University Hospital, Beijing (J. Liu); The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an (J. Lei); Maternal and Child Health Care Hospital of Uygur Autonomous Region, Urumqi, China (L. Jiang); The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an (Z. Liu); General Hospital of Ningxia Medical University, Yinchuan, China (G. Li); Chongqing Health Center for Women and Children, Chongqing, China (Q. Li)

Main Article

Table 1

Characteristics of infants <3 months of age with invasive GBS disease, by disease onset, China, January 1, 2015–December 31, 2017*

Characteristics Early-onset disease, n = 146 Late-onset disease, n = 158 Total, n = 304
Median age at diagnosis, mo (IQR)
 0 (0–1)
 21(15–46)
 8 (0–22)
Sex
M 74 (50.7) 64 (40.5) 138 (45.4)
F
 72 (49.3)
 94 (59.5)
 166 (54.6)
Birth weight, g
Median (IQR) 3,175 (2,700–3,500) 3,185 (2,800–3,500) 3,185 (2,725–3,500)
1,500–2,500 26 (17.8) 21(13.3) 47 15.5)
<1,500
 5 (3.4)
 8 (5.1)
 13 (4.3)
Site of delivery
Sentinel hospital 115 (78.8) 84 (53.2) 199 (65.5)
Other hospital
 31 (21.2)
 74 (46.8)
 105 (34.5)
Median gestational age, wk (IQR) 39 (36–40) 39 (37–40) 39 (37–40)
<34 17 (11.6) 13 (8.2) 30 (9.9)
34–37 22 (15.1) 19 (12.0) 41 (13.5)
≥37
 107 (73.3)
 126 (79.8)
 233 (76.6)
Delivery type
Vaginal 97 (66.4) 94 (59.5) 191 (62.8)
C-section 40 (27.4) 62 (39.2) 102 (33.6)
Forceps 7 (4.8) 1 (0.6) 8 (2.6)
Unknown
 2 (1.4)
 1 (0.6)
 3 (1.0)
Specimen type
Blood 107 (73.3) 78 (49.4) 185 (60.9)
Cerebrospinal fluid 5 (3.4) 19 (12.0) 24 (7.9)
Blood and cerebrospinal fluid
 34 (23.3)
 61 (38.6)
 95 (31.2)
Bacterial infections†
Sepsis 122 (83.6) 121 (76.6) 243 (79.9)
Pneumonia‡ 76 (52.1) 50 (31.7) 126 (41.4)
Meningitis 18 (12.3) 69 (43.7) 87 (28.6)
Sepsis and pneumonia 62 (42.5) 35 (22.2) 97 (31.9)
Sepsis and meningitis 7 (4.8) 43 (27.2) 50 (16.4)
Pneumonia and meningitis
 2 (1.4)
 2 (1.3)
 4 (1.3)
Clinical symptoms†
Fever 38 (26.0) 121 (76.6) 159 (52.3)
Breathing problems 83 (56.9) 38 (24.1) 121 (39.8)
Cyanosis 32 (21.9) 10 (6.3) 42 (13.8)
Seizures 4 (2.7) 20 (12.7) 24 (7.9)
Limpness or stiffness 5 (3.4) 10 (6.3) 15 (4.9)
Poor feeding 13 (8.9) 27 (17.1) 40 (13.2)
Irritability
 4 (2.7)
 15 (9.5)
 19 (6.3)
Median length of hospitalization, d (IQR)
 15 (12–19)
 18 (13–32)
 16 (12–26)
Discharge outcome
Recovered 105 (71.9) 100 (63.3) 205 (67.4)
Transferred to other hospitals 4 (2.7) 13 (8.2) 17 (5.6)
Died 4 (2.7) 3 (1.9) 7 (2.3)
Abnormal neurology at discharge 5 (3.4) 12 (7.6) 17 (5.6)
Condition improved 12 (8.2) 16 (10.1) 28 (9.2)
Discharge requested 16 (11.0) 14 (8.9) 30 (9.9)

*Values are no. (%) except as indicated. GBS, group B Streptococcus; IQR, interquartile range.
†Cases could have >1.
‡As assessed by attending physician by using criteria from Zhu Futang Practice of Pediatrics (11).

Main Article

Page created: October 15, 2019
Page updated: October 15, 2019
Page reviewed: October 15, 2019
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