To the Editor: The study by Dr Phares and colleagues1 concluded that there was an overall reduction in the incidence of group B streptococcal disease in neonates within the first 6 days of life for the period 2003 to 2005 compared with 1999 to 2001. This decrease coincided with revised disease prevention guidelines in 2002. The study shows a reduction only in the number of positive cerebrospinal fluid and blood cultures. However, the rate of positive cultures is not an accurate and exclusive measure of the incidence of invasive streptococcal disease. This study's approach is particularly problematic for assessing the epidemiology of early onset sepsis.
Nanan RKH, Singh G, Poulton A. Reductions in Incidence of Invasive Group B Streptococcal Disease in the United States. JAMA. 2008;300(14):1649–1650. doi:10.1001/jama.300.14.1649-b
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