A study on early-onset neonatal group B streptococcal infection, Bulgaria, 2007–2011

Todorova-Christova, M.; Decheva, Antoaneta; Nikolov, A; Slancheva, B; Christova, Emilia; Shopova, E; Hitrova, S; Masseva, A; Yarakova, N; I, Kraleva; Takova, T.S.; Dimitrova, Nadya; Dobreva, Atanaska

doi:10.1016/j.arcped.2014.06.023

Cited by 4 publications

(3 citation statements)

References 12 publications

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“…Early onset GBS infection is defined as GBS infection during the first 6 days of life [ 1 – 3 , 5 , 6 , 9 ]. The infection can be acquired through rupture of amniotic membranes (especially if prolonged) or during passage through the birth canal.…”

Section: Discussionmentioning

confidence: 99%

“…The organism can spread from the mother to the neonate during vaginal delivery. The vast majority of neonatal infections caused by GBS occur within the first 6 days of life [ 1 – 3 , 8 , 9 ]. While early onset GBS infection (from birth to 6 days) often presents as sepsis, pneumonia, and, less commonly, meningitis, late onset GBS infection (from 7 days to 89 days) more commonly presents as bacteremia, meningitis, and, less commonly, other focal infections such as cellulitis, lymphadenitis, and bone/joint infection [ 1 , 8 , 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

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

Hon

Chan

et al. 2017

Case Reports in Pediatrics

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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.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

Hon

Chan

et al. 2017

Case Reports in Pediatrics

View full text Add to dashboard Cite

show abstract

“…The organism can spread from the mother to the neonate during vaginal delivery. Most neonatal infections caused by GBS occur within the first 6 days of life [ 11 - 14 ]. While early-onset GBS infection (from birth to 6 days) often presents as sepsis, pneumonia, late-onset GBS infection (from 7 days to 89 days) more commonly presents as bacteremia, meningitis, and, less commonly, other focal infections such as cellulitis, lymphadenitis, and bone/joint infection, contributing to the need of intensive care supports [ 2 , 11 - 15 ].…”

Section: Introductionmentioning

confidence: 99%

Severe Group A and Group B Streptococcus Diseases at a Pediatric ICU: Are they Still Sensitive to the Penicillins?

Hon

Chow

Cheung

et al. 2020

CCP

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Background: Group A β-hemolytic streptococcus (GAS) and Group B streptococcus (GBS) are two common pathogens that are associated with many diseases in children. Severe infections as a result of these two streptococci are albeit uncommon but associated with high mortality and morbidity, and often necessitate intensive care support. This paper aims to review mortality and morbidity severe infection associated with GAS and GBS isolations at a Pediatric Intensive Care Unit (PICU). Methods: All children admitted to PICU of a teaching hospital between October 2002 and May 2018 with laboratory-proven GAS and GBS isolations were included. Results: There were 19 patients (0.7% PICU admissions) with streptococcal isolations (GAS, n=11 and GBS, n=8). Comparing to GAS, GBS affected infants were younger (median age 0.13 versus 5.47 years, 95% CI, 1.7-8.5, p=0.0003), and cerebrospinal fluids more likely positive (p = 0.0181). All GAS and GBS were sensitive to penicillin (CLSI: MICs 0.06 – 2.0 μg/mL), with majority of GAS sensitive to clindamycin and erythromycin, and half of the GBS resistant to clindamycin and erythromycin. Co-infections were prevalent, but viruses were only isolated with GAS (p=0.024). Isolation of GAS and GBS was associated with nearly 40% mortality and high rates of mechanical ventilation and inotropic supports. All non-survivors had high mortality (PIM2) and sepsis scores. Conclusions: Severe GAS and GBS are rare but associated with high mortality and rates of mechanical ventilation and inotropic supports in PICU. The streptococci are invariably sensitive to penicillin. The high PIM2 and Sepsis scores suggest that prompt recognition of sepsis and timely judicious institution of antibiotics and intensive care support may be life-saving for these devastating infections.

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Group B streptococcal immunisation of pregnant women for the prevention of early and late onset Group B streptococcal infection of the neonate as well as adult disease

Kenchington

Lamont

2016

Expert Review of Vaccines

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Early onset neonatal Group B streptococcal disease is preventable. Intrapartum antibiotic prophylaxis has resulted in a significant reduction in neonatal mortality and morbidity. National guidelines for the selection of women eligible for intrapartum antibiotic prophylaxis, whether screening-based or risk-based, differ according to the local burden of disease. Despite the introduction of intrapartum antibiotic prophylaxis, there remains a significant burden of disease, which can be resolved by better adherence to guidelines, rapid identification of maternal colonization or in the future, vaccination. Areas covered: The introduction of a vaccine to women in the third trimester is likely to further reduce the burden of disease and provide benefits beyond the prevention of early neonatal disease, including meningitis and disability following late onset disease. Development of specific polyvalent vaccines continues, but testing has challenges and may require surrogate markers or molecular-based techniques to manipulate antigenicity and immunogenicity. Expert commentary: Group B streptococcal vaccination using conjugated polyvalent vaccines against the major disease causing serotypes of Group B streptococcus, either alone, or in combination with a policy of intrapartum antibiotic prophylaxis, may decrease the burden of Group B streptococcus beyond that achieved by current use of intrapartum antibiotic prophylaxis alone.

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A study on early-onset neonatal group B streptococcal infection, Bulgaria, 2007–2011

Cited by 4 publications

References 12 publications

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

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

Severe Group A and Group B Streptococcus Diseases at a Pediatric ICU: Are they Still Sensitive to the Penicillins?

Group B streptococcal immunisation of pregnant women for the prevention of early and late onset Group B streptococcal infection of the neonate as well as adult disease

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