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Updated: Jun 15, 2026
A Neonatal Imaging Model of Gram-Negative Bacterial Sepsis
Published on: August 12, 2020
The Pediatric Investigators Collaborative Network on Infections in Canada (PICNIC) study of neonatal group B
H D Davies1, J Leblanc, R Bortolussi
1Departments of Pediatrics, Microbiology and Infectious Diseases, University of Calgary and the Child Health Research Unit, Alberta Children's Hospital, Calgary, Alberta;
Insights
Neonatal group B streptococcus (GBS) disease caused significant infant illness and death in Canada in 1992. Over half of these GBS cases may have been preventable with intrapartum antibiotics for mothers with risk factors.
Area of Science:
- Neonatalogy
- Infectious Diseases
- Public Health
Background:
- Group B Streptococcus (GBS) is a leading cause of neonatal infections.
- Understanding GBS disease presentation and outcomes is crucial for prevention strategies.
Purpose of the Study:
- To determine the presentation and medical outcomes of neonatal GBS disease in Canada.
- To describe maternal and obstetrical risk factors associated with neonatal GBS disease.
Main Methods:
- Retrospective review of health records and laboratory databases.
- Involved 105 neonates diagnosed with GBS infections across 13 Canadian pediatric centers in 1992.
Main Results:
- The majority of cases (74.3%) had early-onset disease (EOD), often presenting within 24 hours of delivery.
- Pneumonia was the most common clinical illness (43.8%), followed by bacteremia and meningitis.
- Maternal risk factors were present in 59% of EOD cases, and 39.6% of infants were born preterm.
Conclusions:
- Neonatal GBS disease represented a significant cause of morbidity and mortality in Canadian infants in 1992.
- Over half of identified cases could have been prevented with intrapartum antibiotics for at-risk mothers.
- Further prospective studies are needed to refine risk factors and preventative measures for neonatal GBS infections in Canada.
Objectives:
To determine the presentation and medical outcomes of neonatal group B streptococcus (GBS) disease in Canada, and describe maternal and obstetrical risk factors.
Design:
Retrospective review of health records and laboratory databases using standardized data collection forms.
Setting:
All neonates diagnosed with GBS infections in 1992 at 13 Canadian paediatric centres.
Results:
A total of 105 infants meeting the criteria for neonatal GBS disease were identified. The majority of cases (78 or 74.3%) had early-onset disease (EOD); 78.9% (60 of 76) of these cases presented within 24 h of delivery. Rates of EOD (less than seven days) varied from 0.44/1000 live births to 2.1/1000 live births, with an overall rate of 1.2/1000 live births. Pneumonia was the most common clinical illness (43.8%), followed by bacteremia without focus (23.8%) and meningitis (16.2%). At least one maternal risk factor for neonatal GBS disease was noted in 46 of 78 (59%) infants with EOD. A median of one dose (range one to 23 doses) of intrapartum antibiotics was given in 18 of 75 (24%) of the pregnancies. Overall, the mean gestational age at birth was 36.2+/-4.7 weeks, with 38 of 96 (39.6%) infants having a gestational age at birth younger than 37 weeks (31 of 73 [42.5%] EOD cases were born with a gestational age younger than 37 weeks). The median birth weight was 3099 g (range 610 g to 4830 g). Thirty of 94 (31.9%) infants had a birth weight less than 2500 g. Seventeen (16.2%) infants died.
Conclusions:
In 1992, neonatal GBS disease was a significant cause of morbidity and mortality in Canadian infants. More than half of the cases identified in this study could have been potentially preventable by the use of intrapartum antibiotics for women with known risk factors. There is a need for prospective studies to better define risk factors and preventative measures for neonatal GBS infections in Canada.
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