TY - JOUR
T1 - Early-onset group B streptococcal sepsis
T2 - A current assessment
AU - Weisman, Col Leonard E.
AU - Stoll, Barbara J.
AU - Cruess, David F.
AU - Hall, Robert T.
AU - Merenstein, Gerald B.
AU - Hemming, Val G.
AU - Fischer, Col Gerald W.
N1 - Funding Information:
The group B streptococcus remains a frequent cause of early-onset sepsis in the neonate. Though GBS was first described as a cause of puerperal infections in i938,1 it was not recognized as a major neonatal pathogen for more than 20 year s. 2 The clinica! impact of GBS sepsis was extensively reported through the 1970s, though the most recent Clinical Supported in part by a research grant from the Henry M. Jackson Eoundation (FB8601) and a grant from the National Institute of Child Health and Human Development. The opinions and assertions containei~ t~erein are those of the authors and do not reflect those of the Department Of the Army or the Department of Defense. Submitted for publication Jan. 29, 1992; accepted April 3, 1992. Reprint requests: Leonard E. Weismar/, MD, Department of Pediatrics, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Rd., Bethesda, MD 20814 9/23/38261 reviews are based on patients predominantly from the early 1980s. 36 During this time many strategies have developed to prevent and treat GBS sepsis. In addition, overall neonatal survival has continued to improve during this same pe-
PY - 1992/9
Y1 - 1992/9
N2 - Group B streptococcus (GBS) is a common cause of early-onset sepsis in neonates. The most recent reviews describing incidence, diagnosis, treatment, and outcome evaluated data on patients from the early 1980s. To obtain current information about this disease, we retrospectively evaluated data on neonates with GBS early-onset sepsis from nine hospitals in the United States between Jan. 1, 1987, and Dec., 31, 1989. There were 245 infants with GBS bacteremia identified among 61,809 live births, resulting in an incidence of 0.32%. Ninety-six infants (39%) were preterm (<38 weeks of gestational age). Maternal risk factors for infected preterm and term infants were similar. Antibiotics were administered during parturition in 10% of infants with bacteremia. Mothers of preterm infants received antibiotics up to 48 hours before delivery; mothers of term infants recelved antibiotics less than 4 hours before delivery. All preterm infants with bacteremia had symptoms; 22% of term infants with bacteremia had no symptoms. Group B streptococcal meningitis was confirmed in 6.3% of infants. Although 86% survived, GBS sepsis increased the birth weight-specific mortality rate up to eightfold in preterm infants and more than 40-fold in term infants. Although the incidence of GBS early-onset sepsis is not changing, we speculate that the improved birth weight-specific survival rate and the changing clinical presentation are due to improved intrapartum and neonatal management.
AB - Group B streptococcus (GBS) is a common cause of early-onset sepsis in neonates. The most recent reviews describing incidence, diagnosis, treatment, and outcome evaluated data on patients from the early 1980s. To obtain current information about this disease, we retrospectively evaluated data on neonates with GBS early-onset sepsis from nine hospitals in the United States between Jan. 1, 1987, and Dec., 31, 1989. There were 245 infants with GBS bacteremia identified among 61,809 live births, resulting in an incidence of 0.32%. Ninety-six infants (39%) were preterm (<38 weeks of gestational age). Maternal risk factors for infected preterm and term infants were similar. Antibiotics were administered during parturition in 10% of infants with bacteremia. Mothers of preterm infants received antibiotics up to 48 hours before delivery; mothers of term infants recelved antibiotics less than 4 hours before delivery. All preterm infants with bacteremia had symptoms; 22% of term infants with bacteremia had no symptoms. Group B streptococcal meningitis was confirmed in 6.3% of infants. Although 86% survived, GBS sepsis increased the birth weight-specific mortality rate up to eightfold in preterm infants and more than 40-fold in term infants. Although the incidence of GBS early-onset sepsis is not changing, we speculate that the improved birth weight-specific survival rate and the changing clinical presentation are due to improved intrapartum and neonatal management.
UR - http://www.scopus.com/inward/record.url?scp=0026672891&partnerID=8YFLogxK
U2 - 10.1016/S0022-3476(05)81801-3
DO - 10.1016/S0022-3476(05)81801-3
M3 - Article
C2 - 1517922
AN - SCOPUS:0026672891
SN - 0022-3476
VL - 121
SP - 428
EP - 433
JO - Journal of Pediatrics
JF - Journal of Pediatrics
IS - 3
ER -