(785) Epidemiology and Outcomes of Group B Streptococcal Infections in Hospitalized Children in the U.S.

Introduction: While invasive Group B streptococcal (GBS) infections in children beyond the neonatal period have been reported in several studies, its epidemiology among children aged 1 month to 20 years in the United States is largely unknown. We aimed to describe the prevalence and outcomes of GBS-related hospitalizations in pediatric patients outside of the neonatal period using a large national-level inpatient database.

Methods: ICD-10 codes were used to identify children with GBS at any site (bacteremia, pneumonia, urinary tract infection [UTI], meningitis, skin and soft tissue, and unspecified) in the Kids’ Inpatient Database for 2016 and 2019. Neonates were excluded. Results were analyzed using descriptive statistics and chi-squared analysis.

Results: A total of 7,613 children with GBS were identified out of 4,436,810 discharges (prevalence 0.17%). Seventy nine percent of cases were female. Fifty four percent of cases were observed in late adolescence (age 18-20 years), and 22.6% were in infants 1-11 months of age. Most commonly identified diagnoses were bacteremia/sepsis (12.9%), UTI (12.2%), and meningitis (7.0%). Among late-adolescents, there was a female predominance of 94.1%, with 43.2% of patients in this age group presenting as a UTI. Among infants, 52.2% were female, and 94.0% presented as meningitis. GBS-related hospitalizations were significantly associated with increased length of stay with a mean of 6.53 days (IQR 2-7) compared to 4.34 days (IQR 2-4) in non-GBS hospitalizations (p < 0.001). Within GBS-related hospitalizations, a particularly increased length of stay was found among infants (mean 13.64 [IQR 6-14]), and patients with GBS meningitis (mean 16.85 [IQR 11-21]). GBS infection was associated with increased rates of endotracheal intubation and mechanical ventilation (p < 0.001), and cardiopulmonary resuscitation (p < 0.001). The case fatality rate for GBS-related hospitalization was 0.6%.

Conclusions: Hospitalizations with GBS infection show a bimodal distribution, with peaks in infancy and late adolescence. The site of GBS infection and gender prevalence varies by age group. GBS infection is associated with increased length of stay, and increased rates of invasive mechanical ventilation and
CPR.