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Master of Public Health

Epidemiological Trends of Racial Differences in Early- and Late-Onset Group B Streptococcus Disease in Tennessee

AUTHORS

Hamdan L , Vandekar S , Spieker AJ , Rahman H , Ndi D , Shekarabi ES , Thota J , Rankin DA , Haddadin Z , Markus T , Aronoff DM , Schaffner W , Gaddy JA , Halasa NB , . Clinical infectious diseases : an official publication of the Infectious Diseases Society of America. 2020 10 8; ().

ABSTRACT

BACKGROUND: The rates of early-onset Group B Streptococcus (GBS) disease (EOGBS) have declined since the implementation of universal screening and intrapartum antibiotic prophylaxis guidelines but late-onset (LOGBS) rates remain unchanged. Racial differences in GBS disease rates have been previously documented with Black infants having higher rates of EOGBS and LOGBS, but it is not known if these have persisted. Therefore, we sought to determine the differences of EOGBS and LOGBS disease by race over the past decade in Tennessee.

METHODS: This study used active population-based and laboratory-based surveillance data for invasive GBS disease conducted through Active Bacterial Core surveillance in selected counties across Tennessee. We included infants younger than 90 days and who had invasive GBS disease between 2009-2018.

RESULTS: A total of 356 GBS cases were included, with 60% having LOGBS. EOGBS and LOGBS had decreasing temporal trends over the study period. Overall, there were no changes of temporal trend noted in the rates of EOGBS and LOGBS among White race. However, Black infants had a significantly decreasing EOGBS and LOGBS temporal trends, [(RR=0.87, 95% CI= [0.79, 0.96], P-value=0.007), (RR= 0.90, 95% CI= [0.84, 0.97], P-value=0.003)], respectively.

CONCLUSIONS: Years after the successful implementation of the universal screening guidelines, our data revealed an overall decrease in LOGBS rates, primarily driven by changes among infants of Black race. More studies are needed to characterize the racial disparities in GBS rates, and factors driving them. Prevention measures such as vaccination are needed to have a further impact on disease rates.

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