A risk-based prevention strategy to reduce the incidence of group B streptococcus disease has led to a rise in the number of babies suffering from the infection, according to Dutch research.
The lead author is calling for a change to current practices as a result of the findings, which show a 60% rise in infection in babies younger than three months.
Arie van der Ende, of the Reference Laboratory for Bacterial Meningitis, said: ‘Only offering antibiotic treatment during labour to pregnant women at risk is probably too limited to prevent all group B streptococcal infections in newborn infants.
‘Moving to universal screening of pregnant women by vaginal and rectal swabs for group B streptococcus and offering antibiotic prophylaxis to group B streptococcus positive pregnant women must be considered.’
Using nationwide surveillance data from 1987 to 2011, the team examined group B streptococcus trends before and after the introduction of current guidelines in the Netherlands in 1999.
The analysis revealed that the incidence of early-onset disease increased from 0.11 to 0.19 cases per 1000 live births between 1987 and 2011, and the incidence of late-onset disease increased from 0.03 to 0.13 live births.
There is a similar rise of group B streptococcus infections in babies in the UK where, like the Netherlands, the recommended prevention strategy is based on risk factors.
In the two decades to 2010, rates of group B streptococcus infection in babies aged 0 to 90 days increased by 66% in England and Wales.
Early-onset group B streptococcus infection in babies aged 0 to 6 days increased on average by 1% per annum between 1991 and 2010, with rates increasing by 5% a year since 2005.
Countries that offer a universal screening strategy to pregnant women to identify group B streptococcus carriage, including the US, have seen falls in the rate of these infections in newborn babies of up to 86%.
Chief executive of charity Group B Strep Support, Jane Plumb, said the latest data from the Netherlands should prompt the UK to reconsider its policy.
‘It is encouraging to see the Netherlands call for change. Surely it is inconceivable that the UK will not do the same – after all, what more evidence do we need to show that risk-based prevention is simply not working?’
The research is published in the November 2014 issue of The Lancet Infectious Disease.
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