Authors (including presenting author) :
CHAN YTV(1),HUI SYA(2), MA WLT(3),KONG CWM(4), KWONG LT(5), CHAN D (6), LEE D (7), MOK SL (8), MA V (9), LO YC (9), LEUNG KY(10), LEUNG WC (1)
Affiliation :
(1) Department of Obstetrics & Gynaecology, Kwong Wah Hospital, (2) Department of Obstetrics & Gynaecology, Prince of Wales Hospital, (3)Department of Obstetrics & Gynaecology, Queen Elizabeth Hospital, (4) Department of Obstetrics & Gynaecology, United Christian Hospital, (5) Department of Obstetrics & Gynaecology, Tuen Mun Hospital, (6) Department of Obstetrics & Gynaecology, Queen Mary Hospital, (7) Department of Obstetrics & Gynaecology, Pamela Youde Nethersole Eastern Hospital, (8) Department of Obstetrics & Gynaecology, Princess Margaret Hospital, (9) Department of Health, HKSAR Government, (10)Private Practice
Introduction :
This was a retrospective cohort study reviewing the incidence of early onset GBS disease (EOGBSD), late onset GBS disease (LOGBSD), early onset E coli and late onset E coli infant sepsis in the public health care system of Hong Kong before (from 1 January 2002 to 31 December 2011) and after implementation of universal GBS screening (From 1 January 2012 to 31 December 2020). Early onset GBS/E.coli infections are defined as isolation of GBS or E.coli from blood or cerebrospinal fluid, normally sterile site in liveborn infant less than 7 days of age. If the GBS/E.coli infect
Objectives :
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 on 1 January 2012.
Methodology :
All eight public hospitals with obstetrics services under the Hospital Authority and 31 Maternal and Child Health Centres (MCHC) under the Department of Health participated in this program. Data was retrieved from the clinical and laboratory database of the Hospital Authority using clinical data analysis and reporting system (CDARS) and clinical system of MCHCs.
Result & Outcome :
Of 318740 women culture-based GBS performed in 2012- 2020, 63767 women (20.0%) were screened positive. The incidence of early onset neonatal sepsis reduced significantly from 3.25 to 2.26 per 1000 live births (P<0.05), including EOGBSD (1.03 vs 0.26 per 1000 live births, P<0.05), while the incidences of early onset E.coli sepsis remained similar (0.62 vs 0.61 per 1000 live births, P= 0.88). The incidence of late onset infant sepsis also reduced significantly from 5.16 to 3.94 per 1000 live births (P<0.05), with LOGBSD reduced from 0.70 to 0.39 per 1000 live births (P<0.05) and E.coli sepsis reduced from 1.31 to 1.01 per 1000 live births (P<0.05).
We conclude that universal culture-based GBS screening in Hong Kong has been successful in prevention of EOGBSD, and has not increased the incidence of LOGBSD. E.coli has become more common than GBS in early neonatal sepsis, although the incidence remained similar. Further studies on late onset neonatal sepsis are needed to justify whether the reduction of GBS and E.coli sepsis was associated with GBS screening and Intrapartum antibiotics prophylaxis.
