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Meta-Analysis
. 2020 Nov;26(11):2651-2659.
doi: 10.3201/eid2611.181414.

Systematic Review and Meta-Analyses of Incidence for Group B Streptococcus Disease in Infants and Antimicrobial Resistance, China

Yijun Ding, Yajuan Wang, Yingfen Hsia, Neal Russell, Paul T Heath
Meta-Analysis

Systematic Review and Meta-Analyses of Incidence for Group B Streptococcus Disease in Infants and Antimicrobial Resistance, China

Yijun Ding et al. Emerg Infect Dis. 2020 Nov.

Abstract

We performed a systematic review and meta-analysis of the incidence, case-fatality rate (CFR), isolate antimicrobial resistance patterns, and serotype and sequence type distributions for invasive group B Streptococcus (GBS) disease in infants <1-89 days of age in China. We searched the PubMed/Medline, Embase, Wanfang, and China National Knowledge Infrastructure databases for research published during January 1, 2000-March 16, 2018, and identified 64 studies. Quality of included studies was assessed by using Cochrane tools. Incidence and CFR were estimated by using random-effects meta-analyses. Overall incidence was 0.55 (95% CI 0.35-0.74) cases/1,000 live births, and the CFR was 5% (95% CI 3%-6%). Incidence of GBS in young infants in China was higher than the estimated global incidence (0.49 cases/1,000 live births) and higher than previous estimates for Asia (0.3 cases/1,000 live births). Our findings suggest that implementation of additional GBS prevention efforts in China, including maternal vaccination, could be beneficial.

Keywords: China; GBS; antimicrobial resistance; bacteria; case-fatality rate; group B Streptococcus; group B Streptococcus disease; infants; meta-analyses; newborns; respiratory infections; streptococci; systematic review.

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Figures

Figure 1
Figure 1
Process of study selection of systematic review and meta-analyses of incidence of group B Streptococcus disease in infants and antimicrobial resistance, China. CNKI, China National Knowledge Infrastructure.
Figure 2
Figure 2
Distribution of study locations in systematic review and meta-analyses of incidence of invasive group B Streptococcus disease, by province, China.
Figure 3
Figure 3
Overall incidence risk per 1,000 live births of invasive GBS disease in 13 infants <1–89 days of age, China. Vertical dashed line indicates a visual assessment of heterogeneity of the studies. If the vertical line can be drawn, forest plots indicate that all studies are similar enough to be included for meta-analysis. Error bars indicate 95% CIs. Reference details are provided in the Appendix. ES, effect size; GBS, group B Streptococcus disease.
See this image and copyright information in PMC

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