Early-Onset Pneumococcal Sepsis in Newborn Infants

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.

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Liberal Diagnosis and Treatment of Intrauterine Infection Reduces Early-Onset Neonatal Group B Streptococcal Infection but not Sepsis by Other Pathogens

Infectious Diseases in Obstetrics and Gynecology ◽

10.1155/s1064744900000181 ◽

2000 ◽

Vol 8 (3-4) ◽

pp. 143-150 ◽

Cited By ~ 2

Author(s):

H. Wolf ◽

A. H. P. Schaap ◽

B. J. Smit ◽

L. Spanjaard ◽

A. H. Adriaanse

Keyword(s):

Neonatal Sepsis ◽

Early Onset ◽

Group B Streptococcus ◽

Clinical Signs ◽

Intrauterine Infection ◽

Incidence And Mortality ◽

Group B ◽

Second Period ◽

Onset Group ◽

Early Onset Group

Objective:Comparison of the incidence and case fatality of early-onset group B streptococcus sepsis and sepsis caused by other pathogens in neonates after change of management of intrauterine infection.Methods:All infants delivered from 1988 through 1997 at a gestational age ≥ 24 weeks with a birth weight ≥ 500 gram without lethal congenital abnormalities were eligible for inclusion. Infants delivered by cesarean section before the onset of labor or rupture of membranes were excluded. During the first period (1988–1991) intrauterine infection was diagnosed by a temperature > 38℃, during the second period (1992–1997) this diagnosis was made at a lower temperature (≥ 37.8℃) or by fetal tachycardia ≥ 160/min. Treatment of intrauterine infection was similar during both periods with 3 × 2 gram amoxicillin and 1 × 240 mg gentamicin every 24 hours intravenously during labor. Prophylactic treatment during labor was only given to women with a history of an earlier infant with early-onset group B streptococcus sepsis.Results:During the first period 6,103 infants were included, during the second period 8,504. Intrauterine infection was diagnosed and treated more often in the second period (7.1% vs. 2.6%). The incidence of early-onset group B streptococcus sepsis was significantly lower in the second period than in the first period [0.2% vs. 0.4%; OR 0.5 (0.3–0.9)] and survival without disability higher [80% vs. 52%; OR 4.5 (1.4–16.5)]. However, in both periods the overall incidence of neonatal sepsis (3.6% vs. 3.5%) and overall mortality because of sepsis (14.3% vs.13.1%) were similar.Conclusions:Although the early detection of clinical signs of intrauterine infection might have been effective for the prevention of serious sequelae of early-onset group B streptococcus sepsis the overall incidence and mortality from neonatal sepsis remained unchanged. Evaluation of preventive measures for early-onset group B streptococcus sepsis should always take the incidence of neonatal sepsis caused by other pathogens into account. Infect. Dis. Obstet. Gynecol. 8:143–150, 2000.

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Significance of Radiographic Findings in Early-Onset Group B Streptococcal Infection

PEDIATRICS ◽

10.1542/peds.60.3.360 ◽

1977 ◽

Vol 60 (3) ◽

pp. 360-363 ◽

Cited By ~ 1

Author(s):

Lawrence D. Lilien ◽

Vivian J. Harris ◽

Rosita S. Pildes

Keyword(s):

Early Onset ◽

Streptococcal Infection ◽

Group B Streptococcus ◽

Hyaline Membrane Disease ◽

Control Group ◽

Term Infants ◽

Radiographic Findings ◽

Group B ◽

Onset Group ◽

Early Onset Group

Chest radiographs of 73 neonates with early-onset group B Streptococcus (GBS) infection were reviewed. Eighty-six percent of the infants were premature (< 38 weeks); 68% weighed ≤ 1,500 g. In infants weighing ≤ 1,500 g, the predominant radiographic pattern was hyaline membrane disease (HMD) (80%). There was a significant increase in radiographic HMD in 1,000 to 1,500-g neonates with GBS infection (77%) when compared to a control group of infants without GBS infection (44%). Mortality in 1,000 to 1,500-g infants with GBS infection and radiographic HMD (95%) was also significantly higher than in the control group of infants with HMD and no GBS infection (38%). In larger premature and full-term infants, the radiographic findings were not specific and also were not helpful in distinguishing GBS infection from other newborn respiratory disorders.

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