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Hospital clusters of invasive Group B Streptococcal disease: A systematic review.
Journal of Infection ( IF 28.2 ) Pub Date : 2019-11-13 , DOI: 10.1016/j.jinf.2019.11.008
Simon M Collin 1 , Peter Lamb 1 , Elita Jauneikaite 2 , Kirsty Le Doare 3 , Roberta Creti 4 , Alberto Berardi 5 , Paul T Heath 6 , Shiranee Sriskandan 7 , Theresa Lamagni 8
Affiliation  

OBJECTIVES To characterize outbreaks of invasive Group B Streptococcal (iGBS) disease in hospitals. METHODS Systematic review using electronic databases to identify studies describing iGBS outbreaks/clusters or cross-infection/acquisition in healthcare settings where 'cluster' was defined as ≥2 linked cases. PROSPERO CRD42018096297. RESULTS Twenty-five references were included describing 30 hospital clusters (26 neonatal, 4 adult) in 11 countries from 1966 to 2019. Cross-infection between unrelated neonates was reported in 19 clusters involving an early-onset (<7 days of life; n = 3), late-onset (7-90 days; n = 13) index case or colonized infant (n = 3) followed by one or more late-onset cases (median serial interval 9 days (IQR 3-17, range 0-50 days, n = 45)); linkage was determined by phage typing in 3 clusters, PFGE/MLST/PCR in 8, WGS in 4, non-molecular methods in 4. Postulated routes of transmission in neonatal clusters were via clinical personnel and equipment, particularly during periods of crowding and high patient-to-nurse ratio. Of 4 adult clusters, one was attributed to droplet spread between respiratory cases, one to handling of haemodialysis catheters and two unspecified. CONCLUSIONS Long intervals between cases were identified in most of the clusters, a characteristic which potentially hinders detection of GBS hospital outbreaks without enhanced surveillance supported by genomics.

中文翻译:

侵入性B组链球菌疾病的医院群:系统评价。

目的确定医院中侵袭性B组链球菌(iGBS)疾病的爆发特征。方法使用电子数据库进行系统综述,以鉴定描述在“聚类”定义为≥2个关联病例的医疗机构中iGBS爆发/集群或交叉感染/获取的研究。PROSPERO CRD42018096297。结果纳入了25篇参考文献,描述了1966年至2019年在11个国家中的30个医院群(26例新生儿,4名成人)。据报道,不相关的新生儿之间有交叉感染,涉及19个群,涉及早发(生命<7天; n)。 = 3),晚期发作(7-90天; n = 13)指数病例或定植婴儿(n = 3),然后是一或多个晚期发作病例(中位连续间隔9天(IQR 3-17,范围0) -50天,n = 45));通过在3个簇中进行噬菌体分型,在8个簇中进行PFGE / MLST / PCR确定连接 WGS在4中采用了非分子方法,在4中采用了非分子方法。假定在新生儿群集中的传播途径是通过临床人员和设备进行的,特别是在人群拥挤和患者与护士比例高的时期。在4个成群的簇中,一个归因于呼吸道病例之间飞沫扩散,一个归因于血液透析导管的处理,另外两个归因于未明确的。结论在大多数集群中,病例之间的间隔很长,这一特征可能会阻碍GBS医院暴发的检测,而不会得到基因组学的加强监测。一种归因于呼吸道病例之间的飞沫扩散,一种归因于血液透析导管的处理,另外两种归因于未指定。结论在大多数集群中,病例之间的间隔很长,这一特征可能会阻碍GBS医院暴发的检测,而不会得到基因组学的加强监测。一种归因于呼吸道病例之间的飞沫扩散,一种归因于血液透析导管的处理,另外两种归因于未指定。结论在大多数集群中,病例之间的间隔很长,这一特征可能会阻碍GBS医院暴发的检测,而不会得到基因组学的加强监测。
更新日期:2019-11-13
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