Group B Streptococcal sepsis: an old or ongoing threat?

Area of Science:

• Neonatal infectious diseases
• Epidemiology
• Infection control

Background:

• Group B Streptococcus (GBS) is a significant cause of severe neonatal infections, including early-onset disease (EOD) and late-onset disease (LOD).
• LOD can originate from nosocomial sources, posing a risk to vulnerable infants in neonatal intensive care units (NICUs).
• This report details three GBS infection cases in very low birth weight infants within an Italian NICU.

Observation:

• A cluster of GBS infections, including one EOD and two LOD cases, occurred within a 16-day period in the same NICU ward.
• The identified GBS strains exhibited identical antibiotic susceptibility patterns.
• Pulsed-field gel electrophoresis (PFGE) confirmed the clonal relatedness of the EOD and LOD strains.

Findings:

• Active surveillance and epidemiological investigation identified the GBS cluster.
• PFGE analysis demonstrated indistinguishable profiles for the LOD strains and close relatedness to the EOD strain.
• Implementation of strict infection control measures, including audits for isolation precautions and hand hygiene, was associated with the cessation of the outbreak.

Implications:

• The study underscores the persistent threat of GBS in NICU settings and the importance of robust surveillance programs.
• Effective infection control strategies are crucial for preventing and managing GBS outbreaks in vulnerable neonatal populations.
• Prompt identification and intervention, including molecular typing and enhanced hygiene protocols, are essential to contain nosocomial GBS transmission.