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Invasive group B streptococcal disease in children beyond early infancy
S M Hussain1, G S Luedtke, C J Baker
1Department of Pediatrics, University of Tennessee, Memphis, USA.
Insights
Invasive group B Streptococcus (GBS) infections are rare in children over 3 months old. This study reviewed 18 cases, finding bacteremia without a focus as the most common manifestation.
Area of Science:
- Pediatrics
- Infectious Diseases
- Microbiology
Background:
- Invasive group B Streptococcus (GBS) infections are well-documented in neonates, but data on older children is limited.
- Group B Streptococcus is a significant cause of neonatal sepsis and meningitis.
- Understanding GBS epidemiology in older children is crucial for infection control.
Purpose of the Study:
- To describe the clinical characteristics and serotype distribution of invasive GBS infections in pediatric patients older than 3 months.
- To identify risk factors and common manifestations of GBS infection in this age group.
Main Methods:
- Retrospective review of infection control records from LeBonheur Children's Medical Center (1986-1993).
- Identified 143 patients with GBS from sterile body fluid; focused on 18 patients > 3 months old.
- Analyzed medical records for demographics, clinical presentation, serotypes, and outcomes.
Main Results:
- 18 patients aged 15 weeks to 18 years (median 13 months) had invasive GBS.
- Bacteremia without a clear source was the most common presentation (9 patients).
- Serotype III was most frequent (4 isolates), associated with bacteremia. Toxin-producing serotype V strains caused sepsis and meningitis in specific cases.
Conclusions:
- Invasive GBS infections can occur in older children, presenting with diverse clinical manifestations.
- Serotype distribution and specific strains (e.g., toxin-producing V) may influence disease presentation.
- Further research is needed to understand the full spectrum of GBS in non-neonatal populations.
Abstract:
There is little information available on invasive group B Streptococcus (GBS) infection in pediatric patients older than 3 months of age. Review of infection control records at LeBonheur Children's Medical Center from January 1, 1986, to June 30, 1993, identified 143 patients with a positive GBS culture from normally sterile body fluid. Medical records of 18 (13%) patients > 3 months old with their first GBS infection were reviewed. Age range was 15 weeks to 18 years (median age, 13 months). Ten were black and 11 were girls. Five infants had a history of premature birth and 2 infants were infected with human immunodeficiency virus. The serotype distribution of 12 available GBS isolates was 4 type III, 2 each type V and Ia and 1 each type Ia/c, Ib/c, II and II/c. Bacteremia without a focus (9 patients) was the most common clinical manifestation. All 4 type III isolates were associated with bacteremia. One infant with human immunodeficiency virus infection had sepsis and bullous desquamation; a toxin-producing type V strain was isolated from her blood. Two adolescents with ventriculoperitoneal shunts had meningitis, including one whose cerebrospinal fluid also grew a type V strain. Other clinical manifestations were septic arthritis, endocarditis (Ia, II/c), central venous catheter (Ia/c) and ventriculostomy infections.