Early‐onset group B streptococcal infections in Aboriginal and non‐Aboriginal infants

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Abstract
Objectives To survey early‐onset neonatal infections in Australian and New Zealand neonatal units and to compare the incidence of group B streptococcal (GBS) sepsis among Aboriginal and non‐Aboriginal babies. Design Second year of an ongoing longitudinal, prospective study. Setting Nine Australian units and one New Zealand unit with level 3 neonatal care and one Australian unit with level 2 care, between October 1992 and September 1993 inclusive. Outcome measures Episodes of early‐onset sepsis (within 48 hours of birth), causative organisms, mortality, birthweight and gestational age. Subjects Babies in the neonatal units with early‐onset systemic sepsis, either born in attached maternity hospitals or referred. Results In the Australian units there were 100 episodes of early‐onset sepsis (incidence among babies born in attached maternity hospitals of 2.9 per 1000 live births). GBS was the commonest infecting agent (70% of cases) and caused all 12 cases of early‐onset meningitis. The mortality from early‐onset sepsis was 10%. The incidence of GBS sepsis was 1.7 per 1000 live births in non‐Aboriginal babies and 5.2 per 1000 in Aboriginal babies (odds ratio, 3.1; 95% confidence interval, 1.4‐6.6). Conclusions Early‐onset GBS sepsis is more than three times as common in Aboriginal babies delivered in hospital than in non‐Aboriginal babies. Four of seven Australian maternity hospitals surveyed had no firm policy for reducing the incidence of early‐onset GBS sepsis. All should urgently consider such a policy.