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Non-group D alpha-hemolytic streptococci: new neonatal pathogens
Abstract:
Review of the bacteriologic records of a large city-county hospital from 1970 through 1980 has indicated a substantial increase in the frequency of isolation of non-group D alpha-hemolytic streptococci from blood and cerebrospinal fluid of neonates since 1978. These organisms accounted for 23% of all cases of neonatal septicemia and meningitis in 1980, and as a group were exceeded only by group B streptococci (28%) in prevalence. Most neonates (91.2%) had early-onset infection (mean age = 1.4 days); approximately one-third were premature (less than 36 weeks' gestation). Maternal obstetrical complications were common. Nearly 80% of the infants had signs or symptoms suggesting bacterial sepsis. Findings such as concomitant meningitis, shock, chest roentgenogram abnormalities, leukopenia, abnormal numbers of immature neutrophils, and death were infrequent when compared to those accompanying other invasive neonatal bacterial infections, suggesting that non-group D alpha-hemolytic streptococci may be less virulent for the neonate or that neonatal host defense mechanisms are more effective in containing the infection. Careful surveillance for these potential neonatal pathogens seems warranted.
Insights
Non-group D alpha-hemolytic streptococci are increasingly causing neonatal infections like septicemia and meningitis. While prevalent, these infections appear less severe than those caused by other bacteria.
Area of Science:
- Medical Microbiology
- Neonatal Infectious Diseases
- Streptococcal Infections
Background:
- A significant rise in non-group D alpha-hemolytic streptococci infections in neonates was observed between 1970-1980.
- These bacteria became a leading cause of neonatal septicemia and meningitis by 1980.
Purpose of the Study:
- To analyze the increasing incidence and characteristics of neonatal infections caused by non-group D alpha-hemolytic streptococci.
- To compare the clinical presentation and outcomes of these infections with other neonatal bacterial pathogens.
Main Methods:
- Retrospective review of bacteriologic records from a city-county hospital (1970-1980).
- Analysis of patient demographics, clinical signs, and laboratory findings for neonates with identified infections.
Main Results:
- Non-group D alpha-hemolytic streptococci accounted for 23% of neonatal septicemia/meningitis cases in 1980, second only to group B streptococci (28%).
- Most affected neonates (91.2%) had early-onset disease, often premature, with frequent maternal obstetrical complications.
- Severe outcomes like meningitis, shock, and death were less common compared to other invasive neonatal bacterial infections.
Conclusions:
- Non-group D alpha-hemolytic streptococci represent a growing threat in neonatal intensive care units.
- These organisms may possess lower virulence in neonates, or neonates may have enhanced defense mechanisms against them.
- Continuous surveillance for these streptococci is recommended for effective management of neonatal infections.