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Streptococcus pneumoniae infections in the neonate
Jill A Hoffman1, Edward O Mason, Gordon E Schutze
1Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, California, USA. jhoffman@chla.usc.edu
Pediatrics
|November 5, 2003
Summary
Streptococcus pneumoniae infections in the neonate (SPIN) are uncommon but serious, often presenting later in infancy with pneumonia or meningitis. This study highlights a 10.3% mortality rate, emphasizing the need for continued vigilance and research.
Area of Science:
- Pediatric Infectious Diseases
- Neonatal Medicine
- Bacteriology
Background:
- Neonatal sepsis caused by Streptococcus pneumoniae (SPIN) is rare but carries significant risks.
- Previous research indicated associations with prolonged membrane rupture, maternal illness, prematurity, and early-onset pneumonia, with high mortality.
- This study aimed to update the understanding of SPIN epidemiology and clinical outcomes.
Purpose of the Study:
- To review the current epidemiology of Streptococcus pneumoniae infections in neonates (SPIN).
- To analyze the clinical course and outcomes of SPIN.
- To identify risk factors and common presentations of SPIN.
Main Methods:
- Retrospective chart review of neonates (≤30 days) with SPIN from September 1993 to February 2001.
- Data collected from the US Pediatric Multicenter Pneumococcal Surveillance Group across 8 children's hospitals.
- Pneumococcal isolates were serotyped and tested for antimicrobial susceptibility.
Main Results:
- Twenty-nine SPIN cases identified among 4428 S. pneumoniae infections; 66% male, 55% white, mean age 18.1 days.
- Most infants were full-term (≥38 weeks gestation). Common diagnoses included bacteremia, meningitis, and otitis media.
- Mortality was 10.3% overall (14.3% for invasive disease), with deaths occurring within 36 hours of presentation. Non-vaccine serotypes caused 26% of invasive neonatal infections.
Conclusions:
- SPIN cases in this series typically presented later (2-3 weeks of age) and were often full-term infants.
- Pneumonia, meningitis, and otitis media were common presentations.
- The observed mortality rate of 10.3% underscores the severity of these infections in neonates.