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

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 3 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.