Neonatal group B streptococcal septicaemia in a developing country

During a 3-year study at the neonatal intensive care unit, University Hospital of the West Indies, the incidence of group B streptococcal (GBS) septicaemia was 13.6/1,000 admissions and 1.4/1,000 live births. GBS accounted for 35% of blood culture isolates and was the most frequent cause of septicaemia. Underlying disease or other possible predisposing factors were identified in 16 of 25 neonates with GBS septicaemia. Comparison of early onset and late onset disease indicated an increased incidence of prematurity, prolonged rupture of membranes, and respiratory distress in the former and a predominance of meningitis associated cases in the latter. Mortality was 50% for early onset cases, 29% for late onset cases and 36% overall. Antimicrobial therapy and preventive measures which may be appropriate for a developing country are discussed.