Strategies for Preventing Neonatal Group B Streptococcal Disease

1986 ◽  
Vol 7 (S2) ◽  
pp. 137-143 ◽  
Author(s):  
Donald A. Goldmann
Keyword(s):  
Early Onset ◽  
Bacterial Infections ◽  
Late Onset ◽  
Wide Spectrum ◽  
Group B Streptococcus ◽  
Case Fatality ◽  
Chemotherapeutic Agents ◽  
Life Threatening ◽  
Additional Approach ◽  
Group B

Despite increased awareness and the availability of potent chemotherapeutic agents, the Group B streptococcus remains the leading cause of life-threatening bacterial infections in the neonatal period. The majority of infections occur in the first few days of life. These so-called “early-onset” infections are often fulminant and are associated with a very high case fatality rate, ranging from more than 20% in recent reports to as high as 80% in older series. “Late-onset” disease occurs, by definition, after the first week of life. It usually presents with meningitis, although a wide spectrum of infections has been reported, including cellulitis, adenitis, septic arthritis, and osteomyelitis. Late-onset disease is usually less serious than early-onset disease, although deaths do occur and major sequelae are not rare. Accordingly, attempts to prevent group B streptococcal infections have concentrated on the more common and frequently lethal early-onset disease. Strategies that have been considered to date include antibiotic- and immuno-prophylaxis. In the preceding article, Easmon advocates an additional approach; topical use of the antiseptic Chlorhexidine gluconate in the vagina during labor.

Early-Onset Pneumococcal Sepsis in Newborn Infants

PEDIATRICS ◽  
1977 ◽  
Vol 60 (3) ◽  
pp. 352-355
Author(s):  
Robert Bortolussi ◽  
Theodore R. Thompson ◽  
Patricia Ferrieri
Keyword(s):  
Early Onset ◽  
Streptococcal Infection ◽  
Group B Streptococcus ◽  
Newborn Infants ◽  
Clinical Signs ◽  
Pneumococcal Sepsis ◽  
Life Threatening ◽  
Group B ◽  
Onset Group ◽  
Early Onset Group

Five infants with pneumococcal sepsis presented with respiratory distress and clinical signs of infection in the first day of life. Although there was no apparent epidemiological relationship among the patients, four of the five were seen within a 12-month period. Pneumonia, prolonged rupture of fetal membranes, and prematurity were features in these patients. Three infants died, two within 12 hours of diagnosis. Streptococcus pneumoniae was isolated from the vagina of three of the mothers; in two, the serotype was identical to that recovered from their infants. Clinical features of neonatal pneumococcal sepsis are similar to those of early-onset group B streptococcal infection. Like the group B Streptococcus, S. pneumoniae acquired from the maternal vagina is a potential life-threatening pathogen in the newborn period.

Group B Streptococcus (Streptococcus agalactiae)

2018 ◽  
Author(s):  
Kirsty Le Doare ◽  
Christine E. Jones ◽  
Paul T. Heath
Keyword(s):  
Early Onset ◽  
Late Onset ◽  
Group B Streptococcus ◽  
Significant Risk ◽  
Neonatal Infection ◽  
Significant Risk Factor ◽  
Invasive Disease ◽  
Neurodevelopmental Outcomes ◽  
Intrapartum Antibiotic ◽  
Group B

Group B Streptococcus (GBS) is a leading cause of early neonatal infection and neonatal mortality, with long-term adverse neurodevelopmental outcomes in up to 50% of survivors of GBS meningitis. GBS has a likely underappreciated role in causing preterm birth and stillbirth. GBS colonizes the vagina and gastrointestinal tract of the pregnant woman, and transmission to the infant occurs during or just before delivery. Although the majority of these infants do not develop invasive disease, maternal colonization is a prerequisite for early onset disease (0–6 days of life, most commonly associated with sepsis and respiratory distress) and a significant risk factor for late onset disease (7–89 days of life, most commonly associated with sepsis and meningitis). The introduction of intrapartum antibiotic prophylaxis has resulted in significant declines in the incidence of early onset disease but provides no protection against late onset disease.

scholarly journals Late Onset Streptococcus agalactiae Meningitis following Early Onset Septicemia: A Preventable Disease?

2017 ◽  
Vol 2017 ◽  
pp. 1-4
Author(s):  
Kam Lun Hon ◽  
King Hang Chan ◽  
Pak Long Ko ◽  
King Woon So ◽  
Alexander K. C. Leung
Keyword(s):  
Streptococcus Agalactiae ◽  
Early Onset ◽  
Late Onset ◽  
Group B Streptococcus ◽  
Cost Effective ◽  
Rapid Onset ◽  
Current Treatment ◽  
Effective Solution ◽  
Birth Canal ◽  
Group B

We report a neonate who presented with early onset Streptococcus agalactiae or group B streptococcus (GBS) septicemia within 24 hours of birth. After discharge at day 14, she went on to develop late onset GBS meningitis at 36 days of age. The infant was treated with intravenous antibiotics on both occasions and eventually discharged home with no apparent sequelae. We address issues associated with GBS infection in infancy including the demographics, risk factors, and the risk of late onset GBS meningitis following an early onset GBS infection. The major source of GBS in early onset GBS disease is maternal birth canal GBS colonization. On the other hand, nosocomial cross-infection is an important source of GBS in late onset disease. Penicillin remains the current treatment of choice for GBS infection. Given the rapid onset and progression within hours of birth and lack of an effective solution for preventing late onset GBS, administration of an effective GBS vaccine in pregnancy could provide a sensible and cost-effective solution in all settings.

scholarly journals Epidemiological Characterization of Group B Streptococcus Infections in Alberta, Canada: An Update from 2014 to 2020

2021 ◽  
Author(s):  
Angela Ma ◽  
L. Alexa Thompson ◽  
Thomas Corsiatto ◽  
Donna Hurteau ◽  
Gregory J. Tyrrell
Keyword(s):  
Early Onset ◽  
Late Onset ◽  
Group B Streptococcus ◽  
Content Type ◽  
Adult Disease ◽  
Invasive Infections ◽  
Group B ◽  
Epidemiological Characterization

This work describes the epidemiology of invasive infections caused by the bacterium group B Streptococcus (GBS) in Alberta, Canada. We show that rates of invasive GBS disease have increased from 2014 to 2020 for both adult disease and late-onset disease in neonates, whereas the rate of early onset disease in neonates has decreased. We also show that the rate of resistance to erythromycin (an antibiotic used to treat GBS) has also increased in this time.

Group B Streptococcus

1986 ◽  
Vol 7 (S2) ◽  
pp. 135-137 ◽  
Author(s):  
Charles S.F. Easmon
Keyword(s):  
United States ◽  
Early Onset ◽  
Western Europe ◽  
Late Onset ◽  
Group B Streptococcus ◽  
The United States ◽  
Group B Streptococci ◽  
Neonatal Group ◽  
Group B ◽  
Portal Of Entry

Over the past 25 years group B streptococci have become established as one of the main bacterial pathogens of the neonate in Western Europe and the United States. The attack rate of 0.25/1,000 live births found by Mayon White in Great Britain1 appears typical of many European countries. However, in some centers in the United States attack rates can be over 10 times higher.Two types of neonatal group B streptococcus (GBS) diseases exist, “early” and “late” onset. Early onset disease usually presents within the first few days of life. Often the most serious infections are present at birth or seen within a few hours. Early onset disease presents with pneumonia, respiratory distress and shock. Bacteremia is normally present and meningitis may occur. Mortality is high (50% to 75%). The portal of entry is probably the respiratory tract. Infants normally acquire the infecting organism from their mothers. Heavy maternal and infant colonization, prolonged rupture of membranes, prematurity, and obstetric complications are all risk factors.Delayed onset disease, as its name suggests, presents after the first week of life, primarily with bacteremia and meningitis. Mortality is much lower than for the early onset form, but still appreciable for a bacterial infection (14% to 18%). Its epidemiology is uncertain.

scholarly journals Group B streptococcal neonatal infections in Rio Grande do Sul, Brazil

2001 ◽  
Vol 43 (5) ◽  
pp. 243-246 ◽  
Author(s):  
Ernani MIURA ◽  
Maria Cristina MARTIN
Keyword(s):  
Blood Culture ◽  
Neonatal Sepsis ◽  
Early Onset ◽  
Late Onset ◽  
Group B Streptococcus ◽  
Neurological Deficits ◽  
Neonatal Infections ◽  
Laboratory Findings ◽  
Early Onset Sepsis ◽  
Group B

Group B Streptococcus is the most common pathogen found in neonatal sepsis in North America. OBJECTIVES: We describe 15 cases of neonatal infections by Group B Streptococcus (Streptococcus agalactiae) at a Neonatal Intensive Care Unit of a public and teaching hospital. METHODS: We conducted a study at Hospital de Clínicas de Porto Alegre, from January 1st, 1996 to June 30, 1999. Diagnosis of neonatal infection was established according to the findings of Group B Streptococcus in blood culture associated with alterations resembling sepsis on the basis of clinical picture and laboratory findings. RESULTS: Fifteen cases of neonatal infections by Group B Streptococcus were detected. Eleven cases consisted of early-onset sepsis, 2 cases of occult bacteremia and 2 cases of late-onset sepsis. Eight cases had septic shock (53%), 8 cases had pneumonia (53%), and 4 cases had meningitis (27%). Fourteen cases were diagnosed from a positive blood culture, and 1 case from evidence of these bacteria in pulmonary anatomopathological examination. Thirteen cases (87%) were diagnosed before 72 hours of life. We had 3 deaths (20%), and 3 cases of meningitis developing neurological deficits. CONCLUSIONS: Streptococcus Group B is one of the most important pathogens in the etiology of early-onset neonatal sepsis at our hospital, with high mortality and morbidity. However, we do not know the incidence of GBS neonatal infections at other hospitals. More data are needed to establish a basis for trials of different strategies to reduce these infections.

Late-onset brain abscess due to group B Streptococcus

2016 ◽  
Vol 5 (2) ◽  
pp. 165-167
Author(s):  
Antonietta Giannattasio ◽  
Francesco Raimondi ◽  
Alessandra D’Amico ◽  
Silvia Lama ◽  
Maria Immacolata Spagnuolo
Keyword(s):  
Brain Abscess ◽  
Bacterial Infections ◽  
Late Onset ◽  
Group B Streptococcus ◽  
Clinical Manifestations ◽  
Type I ◽  
Csf Analysis ◽  
Long Term Follow Up ◽  
Group B

Abstract Background: Group B Streptococcus (GBS) is the most common pathogen responsible for perinatal bacterial infections. While the early-onset (EO) disease typically presents with pneumonia or sepsis, bacteremia and meningitis represent usual presentation of late-onset (LO) disease. Other clinical manifestations are relatively rare. Highlights: Here we describe an infant with a brain abscess due to a late-onset, GBS serotype I infection. A previously healthy 42-day-old baby presented with insufficient sucking, vomiting, irritability and fever. Cerebrospinal fluid (CSF) analysis, cultures and magnetic resonance imaging (MRI) confirmed the diagnosis of type I group B streptococcal meningitis with brain abscess. The patient made full recovery after a 4-week course of treatment with meropemen and ampicillin. No surgical drainage of the abscess was required. At a 3-year follow-up, the patient had a normal global development with no neurological sequelae. Conclusions: Brain abscess due to GBS late-onset infection is very rarely described. Furthermore, type I GBS is infrequent in late-onset disease. Therapeutic choices in these neonates are challenging because of lack of standards. A long-term follow-up of late-onset disease survivors is mandatory to exclude late developmental impairment.

Pyomyositis as a manifestation of late‐onset group B Streptococcus disease

2021 ◽  
Author(s):  
Akihiko Shimizu ◽  
Mariko Shimizu ◽  
Shigeru Nomura ◽  
Yoshiyuki Yamada
Keyword(s):  
Late Onset ◽  
Group B Streptococcus ◽  
Group B ◽  
Onset Group

scholarly journals Trends in molecular characteristics and antimicrobial resistance of group B streptococci: a multicenter study in Serbia, 2015–2020

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Dusan Kekic ◽  
Ina Gajic ◽  
Natasa Opavski ◽  
Milan Kojic ◽  
Goran Vukotic ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Late Onset ◽  
Group B Streptococcus ◽  
Neonatal Morbidity ◽  
Disease Rate ◽  
Molecular Characteristics ◽  
Group B Streptococci ◽  
Live Births ◽  
Invasive Infections ◽  
Group B

AbstractGroup B Streptococcus (GBS) is a major cause of neonatal morbidity and mortality. Serbia has not fully implemented preventive measures against GBS neonatal diseases. Therefore, we aimed to assess the maternal GBS colonisation and invasive neonatal disease rate, to reveal the trends of antimicrobial resistance and serotype distribution of GBS from various patient groups. Randomly selected non-invasive (n = 991) and all invasive GBS (n = 80) collected throughout Serbia from 2015 to 2020 were tested for antimicrobial susceptibility, capsular typing, and hvgA detection. Overall, 877/5621 (15.6%) pregnant women were colonised with GBS. Invasive GBS infections incidence in infants (0.18/1000 live births) showed a decreasing trend (0.3 to 0.1/1000 live births). Type III was overrepresented in infants with invasive infections (n = 35, 58.3%), whereas type V predominated among colonised adults (n = 224, 25.5%) and those with noninvasive (n = 37, 32.5%) and invasive infections (n = 8, 40%). The hypervirulent clone III/ST17 was highly associated with invasive infections (n = 28, 35%), particularly late-onset disease (n = 9, 47.4%), showing an increase from 12.3 to 14.8%. The GBS resistance to erythromycin and clindamycin was 26.7% and 22.1%, respectively, with an upward trend. The emergence of the hypervirulent clone III/ST17 and the escalation in GBS resistance highlight an urgent need for continuous monitoring of GBS infections.

scholarly journals Novel HAX1 Gene Mutation in a Vietnamese Boy with Severe Congenital Neutropenia

2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
Tham Thi Tran ◽  
Quang Van Vu ◽  
Taizo Wada ◽  
Akihiro Yachie ◽  
Huong Le Thi Minh ◽  
...  
Keyword(s):  
Early Onset ◽  
Bacterial Infections ◽  
Complete Blood Count ◽  
Hereditary Diseases ◽  
Severe Neutropenia ◽  
Sequencing Analysis ◽  
Severe Congenital Neutropenia ◽  
Congenital Neutropenia ◽  
Direct Dna Sequencing ◽  
Life Threatening

Severe congenital neutropenia (SCN) is a rare disease that involves a heterogeneous group of hereditary diseases. Mutations in the HAX1 gene can cause an autosomal recessive form of SCN-characterized low blood neutrophil count from birth, increased susceptibility to recurrent and life-threatening infections, and preleukemia predisposition. A 7-year-old boy was admitted due to life-threatening infections, mental retardation, and severe neutropenia. He had early-onset bacterial infections, and his serial complete blood count showed persistent severe neutropenia. One older sister and one older brother of the patient died at the age of 6 months and 5 months, respectively, because of severe infection. Bone marrow analysis revealed a maturation arrest at the promyelocyte/myelocyte stage with few mature neutrophils. In direct DNA sequencing analysis, we found a novel homozygous frameshift mutation (c.423_424insG, p.Gly143fs) in the HAX1 gene, confirming the diagnosis of SCN. The patient was successfully treated with granulocyte colony-stimulating factor (G-CSF) and antibiotics. A child with early-onset recurrent infections and neutropenia should be considered to be affected with SCN. Genetic analysis is useful to confirm diagnosis. Timely diagnosis and suitable treatment with G-CSF and antibiotics are important to prevent further complication.

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