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Reductions in Incidence of Invasive Group B Streptococcal Disease in the United States—Reply
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In Reply: Both letters question whether prevention of early-onset group B streptococcal disease by intrapartum antibiotic prophylaxis resulted in important disease reductions. From 1993 to 2005, the Active Bacterial Core surveillance (ABCs) documented an 80% decline in invasive early-onset group B streptococcal disease incidence from 1.66 to 0.35 cases per 1000 live births.1 This coincided with widespread uptake of intrapartum antibiotic prophylaxis following issuance of consensus perinatal group B streptococcal disease prevention guidelines in 1996 and a guidelines update in 2002.
Dr Mitchell is correct that the incidence decline (0.13 cases/1000 live births) following the 2002 guidelines was small. This is not surprising because intrapartum antibiotic prophylaxis was already widely used in the 1999-2001 baseline period. Instead, what is notable is that the decline in 2003-2005 follows several years of plateau and that it is of the magnitude predicted when the 2002 guidelines were issued.2 The 2002 recommendation of universal . . . [Full Text of this Article]
Christina Phares, PhD
ctp7@cdc.gov
Anne Schuchat, MD;
Stephanie Schrag, DPhil
National Center for Immunizations and Respiratory Diseases
Centers for Disease Control and Prevention
Atlanta, Georgia
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RELATED LETTERS
Reductions in Incidence of Invasive Group B Streptococcal Disease in the United States
Clyde Mitchell
JAMA. 2008;300(14):1649.
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Reductions in Incidence of Invasive Group B Streptococcal Disease in the United States
Ralph K. H. Nanan, Gurvinder Singh, and Alison Poulton
JAMA. 2008;300(14):1649-1650.
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