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Systemic group D streptococcal infection in newborn infants
Insights
Group D streptococcal neonatal infections, including sepsis and meningitis, are typically low-grade systemic diseases in infants. Prompt antibiotic treatment with penicillin and aminoglycosides leads to favorable clinical responses in most neonates.
Area of Science:
- Neonatal Medicine
- Infectious Diseases
- Streptococcal Infections
Background:
- Group D streptococcus (GDS) can cause serious neonatal infections.
- Neonatal sepsis and meningitis present significant challenges in pediatric care.
Purpose of the Study:
- To review cases of group D streptococcal neonatal sepsis and/or meningitis.
- To analyze clinical presentation, diagnostic findings, and treatment outcomes.
Main Methods:
- Retrospective review of 13 cases at Cincinnati Children's Hospital (1970-1976).
- Analysis of patient demographics, symptoms, laboratory results, and treatment regimens.
Main Results:
- Common symptoms included fever, lethargy, and respiratory distress.
- Blood and/or cerebrospinal fluid (CSF) cultures confirmed infection in most cases.
- 12 of 13 infants received penicillin and an aminoglycoside, with 7 showing rapid improvement.
Conclusions:
- Group D streptococcal infections in neonates often manifest as low-grade systemic disease.
- Appropriate antibiotic therapy, particularly penicillin and aminoglycosides, is effective and leads to favorable outcomes.
Abstract:
Thirteen cases of group D streptococcal neonatal sepsis and/or meningitis were identified at the Cincinnati Children's Hospital from 1970 to 1976. Ages at onset of disease ranged from 1 to 25 days. The most frequent symptoms were fever (five cases), lethargy (five cases), and respiratory difficulty (four cases). Blood cultures for seven infants were positive; CSF cultures for five infants were positive; and CSF and blood cultures for one infant were both positive. In 12 patients, parenteral antibiotic therapy consisted of a penicillin and an aminoglycoside. One infant with a severe meningomyelocele died. The other 12 infants showed a rapid clinical response with seven patients improving within 48 hours of the start of therapy. Infection with group D streptococcus results in a low-grade systemic disease in both full-term and premature infants that responds favorably to appropriate therapy.