449 - Group B Streptococcal Trends during the COVID-19 Pandemic

Monday, May 1, 2023

9:30 AM – 11:30 AM ET

Poster Number: 449
Publication Number: 449.431

Michael Rajnik, Uniformed Services University of the Health Sciences F. Edward Hebert School of Medicine, MOUNT AIRY, MD, United States; Sarah Prabhakar, Uniformed Services University of the Health Sciences F. Edward Hebert School of Medicine, Silver Spring, MD, United States; Apryl Susi, Henry M. Jackson Foundation at USUHS, GWU, Bethesda, MD, United States; Cade M. Nylund, Uniformed Services University of the Health Sciences F. Edward Hebert School of Medicine, Bethesda, MD, United States; ELIZABETH HISLE-GORMAN, Uniformed Services University, Bethesda, MD, United States; Matthew D. Eberly, Uniformed Services University of the Health Sciences F. Edward Hebert School of Medicine, New Braunfels, TX, United States

Presenting Author(s)

MR

Michael Rajnik, MD (he/him/his)

Chief, Division of Pediatric Infectious Diseases
Uniformed Services University of the Health Sciences F. Edward Hebert School of Medicine
MOUNT AIRY, Maryland, United States

Background: Group B Streptococcus (GBS) is a leading cause of invasive neonatal bacterial illnesses. Infections occur in the early (< 7 days) and late-onset post-natal periods (7-89 days). In 2002, the Centers for Disease Control (CDC) first recommended prevention strategies that began to decrease the burden of early onset disease. These relied on screening tests during pregnancy and antibiotics administered during delivery. Rates of early-onset disease decreased as a result of these interventions. During the COVID-19 pandemic, routine prenatal healthcare may have been less optimally delivered during pregnancy; thus, negatively impacting GBS rates.

Objective: To determine if GBS disease trends in neonates changed during the COVID-19 pandemic.

Design/Methods: Inpatient data from the Military Health System (MHS) was used to perform a repeated cross sectional study evaluating trends in GBS rates before and during the COVID-19 pandemic for children less than 6 months. ICD-10 codes were used to identify all cases of GBS. Year 1 of the pandemic was defined as March 2020-Feb 2021, Year 2 was March 2021-Feb 2022, and the pre-pandemic period was March 2018-Feb 2020. Demographic data for sex, sponsor rank, and region was collected. Rates per 100,000 individuals/month were calculated by taking the number of individuals with an inpatient stay for GBS divided by the number of children enrolled in a given month; rate ratios by COVID-19 time period were calculated using Poisson regression analysis, adjusting for demographic variables.

Results: There were 153 unique cases of GBS reported during the study period (Table 1). The monthly cases and rates per 100,000 infants less than six months are depicted in Figure 1. There is a non-statistically significant trend towards increased cases of GBS in both Year 1 and Year 2 of the COVID-19 pandemic, with the highest number of cases in Year 2. Geographic differences in the rate of cases existed with the TRICARE North and West regions being protective when compared to the Southern region (Table 2).

Conclusion(s):
Overall, GBS disease in neonates did not change significantly during the COVID-19 pandemic. This is in contrast to the CDC data which reported a 12% decrease in cases in 2020. This suggests that GBS protocols were followed despite the pandemic. Our analysis is limited as we cannot differentiate between early-onset disease and late-onset disease and the study used population enrollment data into the healthcare system versus live birth data to determine rates of disease. Despite these limitations, the study was able to capture all GBS infections in the MHS during this time period.