Group B streptococcus infection in infancy: 21-year experience

Area of Science:

• Pediatrics
• Infectious Diseases
• Microbiology

Background:

• Group B Streptococcus (GBS) is a leading cause of invasive infections in infants.
• Understanding the clinical spectrum and outcomes of GBS infections is crucial for timely diagnosis and management.

Purpose of the Study:

• To analyze the clinical presentations, outcomes, and antibiotic susceptibilities of invasive Group B Streptococcus infections in children.
• To compare early-onset disease (EOD) and late-onset disease (LOD) in infants with GBS.

Main Methods:

• Hospital-based retrospective review of pediatric GBS infections from January 1980 to March 2000.
• Analysis of clinical data, including onset, symptoms, manifestations, and outcomes.
• Antimicrobial susceptibility testing of GBS strains.

Main Results:

• Of 25 infants, 9 had EOD and 12 had LOD. EOD cases often presented on day 1 of life, with higher rates of pneumonia (66%) and case-fatality (33.3%).
• LOD was predominantly meningitis (77%), with severe sequelae in 40%. Common symptoms included fever, poor activity, respiratory distress, lethargy, and irritability.
• All tested strains were susceptible to penicillin, ampicillin, cefotaxime, and vancomycin; variable susceptibility was noted for erythromycin (62%) and clindamycin (75%). Type III GBS strains were most common.

Conclusions:

• GBS infections in infants exhibit distinct clinical patterns for early-onset and late-onset disease.
• Prompt recognition and appropriate antibiotic therapy are essential, considering potential resistance patterns.
• Type III GBS strains are prevalent and require continued surveillance for antibiotic resistance.