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Updated: Mar 2, 2026
A Neonatal Imaging Model of Gram-Negative Bacterial Sepsis
Published on: August 12, 2020
Case-control study shows that neonatal pneumococcal meningitis cannot be distinguished from group B Streptococcus
Alexandra Arfi1, Robert Cohen2,3,4,5,6, Emmanuelle Varon7
1Hôpital Intercommunal de Créteil, Service de Gynécologie Obstétrique, Université Paris Est, Paris XII, Créteil, France.
Aim:
Streptococcus pneumoniae (S. pneumoniae) is sometimes implicated in neonatal bacterial meningitis. This study described the demographic, clinical and biological features of neonatal S. pneumoniae meningitis and compared pneumococcal and group B streptococcal (GBS) neonatal meningitis.
Methods:
We conducted a case-control study that compared neonates, aged one to 28 days with S. pneumoniae meningitis or GBS meningitis. Each case with S. pneumoniae was randomly matched to four control patients with GBS by age group and study year.
Results:
From 2001 to 2013, the national French paediatric network, which comprises 227 paediatric wards, recorded 831 neonatal cases of meningitis. S. pneumoniae (n = 18, 2.2%) was the fifth infection cause after GBS (n = 464, 55.8%), Escherichia coli (n = 232, 27.9%), Neisseria meningitidis (n = 23, 2.8%) and Listeria monocytogenes (n = 20, 2.4%). Neonatal pneumococcal and GBS meningitis did not differ in demographic data or clinical and biological characteristics. All S. pneumoniae strains were fully susceptible to cefotaxime, and we observed a decrease of 13-valent pneumococcal conjugate vaccine (PCV13) serotypes (88.9%-20.0%) after PCV13 implementation.
Conclusion:
Clinically and biologically, neonatal pneumococcal meningitis could not be distinguished from GBS cases. A herd effect of PCV13 implementation was suggested by the decrease in the prevalence of vaccine serotypes.
Insights
Neonatal meningitis caused by Streptococcus pneumoniae (S. pneumoniae) is clinically similar to group B streptococcal (GBS) meningitis. The 13-valent pneumococcal conjugate vaccine (PCV13) likely reduces S. pneumoniae serotypes.
Area of Science:
- Neonatal infectious diseases
- Bacterial meningitis epidemiology
- Vaccine impact assessment
Background:
- Streptococcus pneumoniae (S. pneumoniae) is an identified cause of neonatal bacterial meningitis.
- Group B Streptococcus (GBS) is a leading cause of neonatal meningitis.
- Understanding the distinct features of S. pneumoniae meningitis is crucial for diagnosis and management.
Purpose of the Study:
- To describe the demographic, clinical, and biological features of neonatal S. pneumoniae meningitis.
- To compare S. pneumoniae meningitis with GBS meningitis in neonates.
- To evaluate the impact of the 13-valent pneumococcal conjugate vaccine (PCV13) on S. pneumoniae serotypes.
Main Methods:
- A case-control study design was employed.
- Neonates (1-28 days) with S. pneumoniae or GBS meningitis were compared.
- S. pneumoniae cases were matched to four GBS controls by age group and study year.
Main Results:
- From 2001-2013, S. pneumoniae accounted for 2.2% of 831 neonatal meningitis cases in France.
- Neonatal S. pneumoniae and GBS meningitis showed no significant differences in demographic, clinical, or biological characteristics.
- A decrease in PCV13 serotypes was observed post-vaccine implementation, with prevalence dropping from 88.9% to 20.0%.
Conclusions:
- Neonatal meningitis due to S. pneumoniae is clinically and biologically indistinguishable from GBS meningitis.
- The 13-valent pneumococcal conjugate vaccine (PCV13) implementation showed a potential herd effect, indicated by reduced vaccine serotype prevalence.
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