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Neonatal group B streptococcal infections in Indian (Asian) babies in South Africa
I E Haffejee1, R H Bhana, Y M Coovadia
1Department of Paediatrics and Child Health, Faculty of Medicine, University of Natal, Congella, South Africa.
Insights
Group B streptococcal (GBS) infections in Asian neonates in South Africa occurred at 2.65/1000 live births. GBS was the leading cause of neonatal septicaemia and meningitis, with a 13.2% mortality rate.
Area of Science:
- Neonatal infections
- Streptococcal diseases
- Public health in South Africa
Background:
- Group B Streptococcus (GBS) is a significant cause of neonatal infections globally.
- Data on GBS infections in Asian neonates in South Africa is limited.
- Neonatal infections pose a substantial threat to infant survival and well-being.
Purpose of the Study:
- To report the incidence and characteristics of GBS infections in Asian neonates in South Africa.
- To determine the contribution of GBS to neonatal septicaemia and meningitis.
- To assess the clinical presentation, complications, and outcomes of GBS infections in this population.
Main Methods:
- Retrospective analysis of GBS infections in Asian neonates over 3.5 years.
- Calculation of incidence rates per 1000 live births.
- Review of clinical data, including onset, presentation, diagnosis, and outcomes.
Main Results:
- The incidence of GBS infections was 2.65/1000 live births.
- Early onset disease (EOD) accounted for 79% of cases, often with onset within 24 hours of birth.
- GBS was the most common organism in neonatal septicaemia (12.3/1000 live births) and the leading cause of bacterial meningitis (89% of cases).
- Neurological signs were present in 40% of EOD cases, but only 13.3% had confirmed meningitis.
- Radiographic findings included hyaline membrane disease in 50% and pneumothorax in one case.
- The overall mortality rate was 13.2%, lower than reported in other studies.
Conclusions:
- GBS is a significant pathogen in Asian neonates in South Africa, contributing substantially to neonatal septicaemia and meningitis.
- Early recognition and management are crucial for improving outcomes.
- The observed mortality rate is lower than in other series, suggesting potential improvements in care or specific population factors.
Abstract:
In this, the first report of group B streptococcal (GBS) infections in Asian neonates in South Africa, the incidence was 2.65/1000 live births over a period of 3.5 years. Early onset disease (EOD), defined as arising less than or equal to 5 days after birth, was present in 79% cases; in most of these, the onset was before the age of 24 h. One baby presented with two episodes of late onset GBS infection. The incidence of culture-proven neonatal septicaemia during the same period was 12.3/1000 live births, GBS being commonest organism isolated. It was also the most frequent cause of bacterial meningitis in the newborn, accounting for 89% cases. Although neurological signs were present in 40% patients with EOD, only 13.3% had CSF-culture-positive meningitis. Radiographic features of hyaline membrane disease were found in half of the babies with EOD and for whom a chest radiograph was performed, while one had a pneumothorax. The overall mortality was 13.2% which is much lower than that reported in other series.