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Recurrent group B streptococcal disease in infants: Who should receive rifampin?
J T Atkins1, G P Heresi, T M Coque
1Department of Pediatrics, The University of Texas Health Science Center, Houston, USA.
Insights
Recurrent group B streptococcus septicemia in a preterm infant was treated with rifampin. Maternal breast milk exposure continued, suggesting combined infant and maternal rifampin treatment for persistent group B streptococcus infections.
Area of Science:
- Neonatal Medicine
- Infectious Diseases
- Microbiology
Background:
- Group B Streptococcus (GBS) is a leading cause of neonatal sepsis.
- Breastfeeding is generally recommended for preterm infants but can transmit GBS.
Observation:
- A preterm infant experienced three episodes of GBS septicemia (type Ia/c).
- Despite infant rifampin treatment after the second episode, GBS exposure persisted via maternal breast milk.
Findings:
- Recurrent GBS septicemia indicates ongoing exposure, potentially from maternal sources.
- Rifampin prophylaxis may be necessary for both mother and infant in persistent GBS cases.
Implications:
- This case highlights the importance of considering maternal transmission in recurrent neonatal GBS disease.
- Combined maternal-infant rifampin therapy could be a strategy to eradicate GBS in such scenarios.
- Further research is needed to establish optimal treatment protocols for recurrent GBS in breastfeeding dyads.
Abstract:
A preterm breast-fed infant had three episodes of type Ia/c group B streptococcus septicemia. After the second episode rifampin was given to the infant, but further Ia/c exposure to maternal breast milk ensued. We propose rifampin treatment for both the mother and infant in cases of recurrent group B streptococcus disease.