Pathogenicity of alpha hemolytic streptococci in the neonate

Alpha hemolytic Streptococcus viridans (AHSV) was found to be the predominant pathogen in neonatal septicemia from 1979 to 1981 at a 1,000-bed voluntary hospital with 5,000 deliveries per year. All but three of the 30 neonates with blood cultures positive for AHSV presented within the first week of life. Most were born at term and had good Apgar scores. The majority of the infants were symptomatic, with respiratory distress being the most common presenting sign. Other common signs included unexplained hyperbilirubinemia and gastrointestinal problems. The one mortality in the group was the smallest and most premature neonate. In the remainder there was good correlation between institution of antibiotic treatment and clinical improvement. Alpha hemolytic Streptococcus viridans should no longer be considered a contaminant if isolated from the blood of a neonate suspected of having sepsis or from cervical or placental cultures in obstetrical patients with complications.