Neonatal Group A Streptococcus Meningitis. Case Report and Literature Review (original) (raw)
Related papers
2021
Background: Streptococcus pneumoniae (S. pneumoniae) is the first leading cause of invasive diseases such as meningitis, bacteremia and pneumoniae in children. In this case we report an early neonatal respiratory distress revealing meningitis caused by S. pneumoniae Serotype 17F through vertical transmission, in the newborn of 3 hours of live. Case description: A male late preterm newborn was born by vaginal delivery at a gestational age of 34 weeks. At 3 hours of life, he was admitted for early moderate neonatal respiratory distress in the Neonatal Medicine and Resuscitation Service. Cerebrospinal fluid culture yielded S. pneumoniae belonging to serotype 17F while the blood culture was negative. The same pneumococcal serotype was recovered from the high vaginal swab of the mother. Both isolates were found susceptible to all tested antibiotics except tetracycline and chloramphenicol to which the strain was resistant. Antibiotherapy management of the child included ceftriaxone at 150mg/kg/day for 21 days, in combination with gentamycin at 5 mg/kg/day for 5 days. ciprofloxacin was added at 40mg/kg/day in two doses for a period of three weeks as the baby presented a hydrocephalus. Conclusion: This finding shows that clinical manifestations of neonatal pneumococcal meningitis may be atypical and/or misleading.
Fatal late onset group B streptococcal meningitis following maternal postpartum sepsis
Paediatrics & child health
Although maternal screening and the administration of prophylactic intrapartum antibiotics have decreased the incidence of early onset group B streptococcal (GBS) disease in neonates, there is still significant morbidity and mortality as a result of neonatal GBS disease.Maternal GBS infections are not uncommon, but with appropriate therapy there is almost a uniformly good outcome. Little is written about the appropriate management of well infants born to mothers with postpartum GBS sepsis.The question of whether well infants born to mothers with GBS puerperal sepsis should be treated empirically with antibiotics and the lack of literature concerning this issue became apparent when an untreated term infant died of late onset GBS meningitis following maternal puerperal GBS sepsis. We describe this event in the following case presentation.With the current paucity of literature regarding the management of well infants born to mothers with postpartum GBS sepsis, it seems prudent to treat...
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2017
Group B Streptococcus (GBS) disease is the leading cause of neonatal bacterial meningitis despite women receiving an intravenous antibiotic prophylaxis (IAP) during labor. We aimed to describe GBS meningitis in children less than 1 year old in France during 2001-2014. Clinical and biological data of GBS meningitis gathered by ACTIV/GPIP and the French National Reference Center for Streptococci were analyzed. The cases were classified by age: 0 to 6 days old (early-onset disease [EOD]), newborns and infants 7 to 89 days old (late-onset disease [LOD]: LOD1, 7-26 days; LOD2, 27-89 days to 3 months) and infants 3 months to 1 year old (infant disease [ID]). Among 848 GBS meningitis cases from 2001-2014, the incidence of EOD decreased by 63.3% (95% confidence interval [95% CI] [43.9; 80.1], p<0.001) and that of LOD increased by 58.1% 95% CI [39.1; 75.5] p<0.001 (52.9% and 64.3% for LOD1 and LOD2). The mean gestational age (GA) decreased significantly for EOD, LOD1, LOD2 and ID cases...
Group B Streptococcal Septicaemia/Meningitis in Neonates in a Singapore Teaching Hospital
The Australian and New Zealand Journal of Obstetrics and Gynaecology, 1998
Our aims were to establish the incidence and clinical characteristics of early and late onset Group B Streptococcal (GBS) septicaemia in neonates in our hospital over a period of 1 year. Routine screening for maternal GBS was not standard practice in the hospital. GBS was isolated from high vaginal swabs (HVS) obtained antenatally or postnatally for risk factors as determined by the obstetrician or neonatologist in charge. Data obtained were analyzed separately and these did not form part of the study. By a system of clinical case review and follow-up, mail, telephone and home visits, the outcome of all 15,062 livebirths in the hospital over a 1-year period were verified and reported. Our results show a low incidence of GBS infection in neonates in the hospital: early onset disease was 0.265 per 1,000 livebirths and late onset a quarter of that. The majority of our cases of early onset GBS disease were in premature infants. Because of our low incidence, prophylaxis schedules would have to ensure an acceptably smaller number of mothers exposed to antibiotics over and above the current level and the cooperation of our obstetricians. We have devised a schedule incorporating a current PROM (prelabour premature rupture of membranes) protocol which would result in only an additional 2.2% of mothers requiring prophylactic antibiotics.
Group A Streptococcus Meningitis in Children
Pediatric Infectious Disease Journal, 2013
Objective: to characterize the epidemiologic burden and the molecular determinants of group a streptococcal (gaS) meningitis among the pediatric population of the state of Paraná, Brazil. Methods: Clinical and epidemiologic data were gathered by a compulsory notification system during the period 2003 to 2011. Bacterial identification, antibiotic resistance profile, emm-typing, pulsed-field gel electrophoresis typing and virulence profile were analyzed by a central reference laboratory. a review of published pediatric cases of gaS meningitis from the last 45 years was undertaken and compared with the Brazilian series. Results: the incidence of gaS meningitis among the pediatric population was 0.06 cases per 100,000 children per year and was associated with a case fatality rate of 43%. neonatal age and the presence of an associated toxic shock syndrome were identified as risk factors for death. a distant focus of infection was present in more than half of the patients in the literature and in 36% in the Brazilian case series. a high diversity of emm-types was associated with gaS meningitis in Brazil. no single virulence determinant could be associated with death. Conclusions: gaS meningitis is associated with high mortality and with a high diversity of gaS emm-types and virulence determinants in Brazil.
Group A streptococcal meningitis: a case report
The new microbiologica, 2013
Streptococcus pyogenes (Group A streptococcus, GAS) is a rare cause of bacterial meningitis, accounting for less than 1% of cases. GAS meningitis has rarely been reported in children, and is associated with a high (46%) rate of morbidity and a high (10-17%) case fatality rate. This paper describes a case of meningitis caused by GAS in a previously healthy child; M protein genotyping demonstrated an emm type 12. Although not common, GAS meningitis must be considered in children vaccinated for other invasive pathogens. Continuous monitoring of the molecular epidemiology of circulating invasive GAS strains is of crucial importance for planning intervention policies.
Purulent Bacterial Meningitis at Birth
2015
Meningitis is an acute inflammation of the protective membranes covering the brain and spinal cord, which are known as the meninges. This infection may be caused by Streptococcus pneumonia bacteria. In this study, we presented the case of a female newborn with meningitis secondary to Streptococcus pneumonia. Her birth weight and height were normal. After 24 hours of birth, the neonate was diagnosed with tachypnea, without presenting any signs of fever or respiratory distress. The newborn was referred to Sheikh Children's Hospital, where chest X-ray showed clear lungs with no evidence of abnormality. Furthermore, the cardiothoracic ratio was normal. A complete blood count demonstrated white blood cell (WBC) count of 5400/uL. In Blood/Culcture ratio (B/C) test, Streptococcus pneumonia was reported, and the results of the cerebrospinal fluid (CSF) analysis confirmed this result. Following 14 days of receiving antibiotic therapy, the results of CSF analysis were within t...
Comparison of early-onset neonatal sepsis caused by Escherichia coli and group B Streptococcus
American Journal of Obstetrics and Gynecology, 2005
Early-onset neonatal sepsis Group B Streptococcus Escherichia coli Objective: The purpose of this study was to compare maternal characteristics and neonatal morbidity and mortality rates that are associated with early-onset neonatal sepsis that is caused by group B Streptococcus and Escherichia coli. Study design: This was a retrospective review of newborn infants with a positive blood culture (and/or cerebrospinal fluid) that was positive for either E coli or group B Streptococcus during the first week of life. Data were abstracted from maternal and neonatal medical records. Results: Among 28,659 deliveries during the study period, 102 episodes of early-onset neonatal sepsis were identified, 61 of which were caused by group B Streptococcus and 41 of which were caused by E coli. E coli sepsis cases had a lower birth weight, a higher percentage with 5-minute Apgar score !7, and a longer stay in the hospital neonatal intensive care unit and required mechanical ventilation more frequently. Death after early-onset neonatal sepsis with E coli was also more frequent. Conclusion: Early-onset sepsis with E coli is associated with more morbidity and a higher mortality rate compared with early-onset group B Streptococcus.
Archives of Disease in Childhood, 1977
All cases of neonatal bacteraemia associated with clinical illness occurring at Hammersmith Hospital, over a 9-year period 1967-1975 inclusive, have been reviewed. The infants studied were those born in the hospital's maternity unit and those admitted from other hospitals from a wide area round London who were ill or of low birthweight. Positive blood cultures occurred in 91 infants, 47 of them in the first 48 hours of life. These 47 infants were analysed separately and divided into three groups, 13 with group B streptococcal infections, 11 with other Gram-positive infections, and 23 with Gram-negative infections. There were no significant differences in birthweight or gesta- tion, in mortality, in incidence of clinically diagnosed respiratory distress syndrome or recurrent apnoea, or in the need for mechanical ventilation between the three groups. The age at which a diagnosis of infection was suspected, and the age at death were both significantly earlier in the group infected with group B streptococcus than in those infected with other organisms (P<001 for both comparisons). There were no significant differences in the incidence of hyaline membrane formation or pneumonia seen at necropsy among the three groups. In some of the earliest deaths in the Gram- negative bacteraemic group, Gram-negative rods comprised the bulk of the hyaline membrane as did cocci in the group B streptococcal group. 1976). To restore a balanced outlook, we have examined all cases of early neonatal bacteraemia occurring in our hospital over a 9-year period.