[Early, severe, neonatal infections due to streptococcus group B. Multicenter retrospective study on the incidence...

Streptococcus group B is often the causal agent in maternofetal infections occurring early. The prevention of fatal fulminant forms is much controversial.

A retrospective multicentric study (10 maternity wards, 5 years, 96.243 live births) was conducted. All cases of early (<48 th) infection due to Streptococcus group B were collected and divided into two groups for comparison: group 1: infant death, and group 2: surviving infants requiring ventilatory assistance for > or = 12 hours. The aim of this study was to determine the incidence of fatal infections and to ascertain he clinical features and laboratory data correlated with death.

The incidence of fatal early maternofetal infection due to Streptococcus group B (group 1) was 14 cases in 96,243 live births (0.14%) or 1 case in 7,143 live births. All newborns who died were symptomatic at 8 hours of life. The factors significantly correlated with death were: lack of antibiotics per partum, which did not [correction of no] altogether prevent severe forms (2/14 deaths and 14/28 survivals had had antibiotic per partum); prematurity; impaired adaptation to birth, early clinical signs and sudden aggravation; lack of an inflammatory syndrome at first work-up; a chest X-ray suggesting hyalin membrane disease; and major non-infectious associated disease.

These findings underscore the importance of antibiotic prophylaxy per partum and the need for immediate paediatric care in case of risk factors.