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Incidence of early and late onset group B streptococcal and Escherichia coli neonatal infection after universal antenatal culture-based screening of group B streptococcus in all public hospitals in Hong Kong: a retrospective cohort study
  • +9
  • Viola Chan,
  • Shuk Yi Annie Hui,
  • Teresa Ma,
  • C. W. Kong,
  • Lee Ting Kwong,
  • Diana Chan,
  • Diana Lee,
  • Sau Lan Mok,
  • Vinci Ma,
  • Yim Chong Lo,
  • Kwok Yin Leung,
  • Wing-cheong LEUNG
Viola Chan
Kwong Wah Hospital

Corresponding Author:[email protected]

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Shuk Yi Annie Hui
Prince of Wales Hospital
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Teresa Ma
Queen Elizabeth Hospital
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C. W. Kong
United Christian Hospital
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Lee Ting Kwong
Tuen Mun Hospital
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Diana Chan
Queen Mary Hospital
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Diana Lee
Pamela Youde Nethersole Eastern Hospital
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Sau Lan Mok
Princess Margaret Hospital
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Vinci Ma
Hong Kong Department of Health
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Yim Chong Lo
Hong Kong Department of Health
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Kwok Yin Leung
Private practice
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Wing-cheong LEUNG
Kwong Wah Hospital
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Abstract

Objective: To compare the incidences of early and late onset neonatal sepsis, including group B streptococcus (GBS) and Escherichia coli (E.coli) before and after implementation of universal screening. Design: Retrospective cohort study Setting: Eight public hospitals with obstetrics services under the Hospital Authority and 31 Maternal and Child Health Centres (MCHC) under the Department of Health in Hong Kong Population: 460552 women attending routine antenatal service from 2009 to 2020. Methods: Universal culture-based GBS screening was offered to eligible women since 2012. Total maternity, births, GBS screening tests, GBS isolated in maternal genital tract, neonatal sepsis with positive blood or cerebrospinal fluid were retrieved from clinical and laboratory database of the Hospital Authority using clinical data analysis and reporting system (CDARS) and clinical system of MCHCs. Main outcome measures: Maternal GBS colonisation rate, early onset GBS disease, early onset E. coli infection, late onset GBS disease, and late onset E. coli infection Results: Of 318740 women with universal culture-based screening, 63767 women (20.0%) were screened positive. After implementation of GBS screening, the incidences of both early and late onset neonatal sepsis reduced significantly, including those caused by GBS. There was no change in the incidence of early onset E.coli sepsis, while the incidence of late onset E.coli sepsis reduced. Conclusions: Universal culture-based GBS screening in Hong Kong has been successful in prevention of early and late onset neonatal sepsis, including those caused by GBS. E.coli has become more common than GBS in early neonatal sepsis, although the incidence remained similar.
13 Feb 2022Submitted to BJOG: An International Journal of Obstetrics and Gynaecology
21 Feb 2022Submission Checks Completed
21 Feb 2022Assigned to Editor
25 Feb 2022Reviewer(s) Assigned
06 Mar 2022Review(s) Completed, Editorial Evaluation Pending
14 Mar 2022Editorial Decision: Revise Major
15 Apr 20221st Revision Received
25 Apr 2022Submission Checks Completed
25 Apr 2022Assigned to Editor
25 Apr 2022Review(s) Completed, Editorial Evaluation Pending
29 Apr 2022Reviewer(s) Assigned
16 May 2022Editorial Decision: Revise Major
14 Jun 20222nd Revision Received
16 Jun 2022Submission Checks Completed
16 Jun 2022Assigned to Editor
16 Jun 2022Review(s) Completed, Editorial Evaluation Pending
17 Jun 2022Reviewer(s) Assigned
21 Jun 2022Editorial Decision: Revise Minor
23 Jun 20223rd Revision Received
27 Jun 2022Submission Checks Completed
27 Jun 2022Assigned to Editor
27 Jun 2022Review(s) Completed, Editorial Evaluation Pending
29 Jun 2022Editorial Decision: Accept