Clinical analysis of 30 cases of neonatal group B streptococcus sepsis

Abstract

Objective To explore the clinical characteristics, treatment and prognosis of neonatal group B streptococcus (GBS) sepsis. Methods According to the onset time and clinical features of the patients, 30 cases of neonatal GBS sepsis in Department of Neonatology, Zhuhai People′s Hospital and ICU of Newborn of Maternity and Child Care Health Hospital of Guangxi from January 2013 to February 2015 were divided into the early-onset group (onset day of the patients ≤7 days) and late-onset group (onset day of the patients >7 days). The clinical manifestations, the examination results of laboratory, imaging examination, treatment and prognosis were retrospectively analyzed. Results Among the newborns diagnosed as neonatal GBS sepsis, there were 19 cases of early-onset sepsis and 11 cases of late-onset sepsis, including 17 males and 13 females, consisting of 24 term infants and 6 premature infants.The early-onset newborns were mainly diagnosed with respiratory symptoms like anhelation, groaning (73.7%, 14/19 cases), late-onset GBS sepsis with high fever (81.8%, 9/11 cases), high frequency of early-onset intraute-rine infection pneumonia (89.5%, 17/19 cases) and late-onset intracranial infection (63.6%, 7/11 cases). The differences between the 2 groups were statistically significant(all P<0.05). Laboratory tests of GBS sepsis showed that the early value of procalcitonin (PCT) increased, while the number of white blood cells, platelet decreased and C-reactive protein (CRP) increased relatively late.Chest X-ray examination showed 16 cases of pneumonia in children, 1 case of pulmonary hemorrhage, 1 case of bilateral pneumothorax. Head CT, B ultrasound, and magnetic resonance imaging discover 1 case of ventricular perivascular hemorrhage, 2 cases of intraventricular hemorrhage with ventricular dilatation and 1 case of subdural effusion.Drug sensitivity test showed that 30 cases of children were sensitive to Penicillin, Vancomycin among which 17 cases (56.66%) were cured, 4 cases (23.33%) were improved, 9 cases died, 6 cases died of abandoning treatment, and the total mortality was 30.00% (9/30 cases). The 6-month follow-up of 9 cases of purulent meningitis newborns showed that there were 2 cases of mild mental retardation and motor dysfunction, 1 case of mild ventricular dilatation with no progressive increase, and 6 cases with no significant sequelae. Conclusion The clinical manifestations of neonatal GBS sepsis are typical.Dynamically monitoring the changes of PCT, CRP, white blood cells and platelet helps to early identify GBS sepsis infection and use sensitive antibiotics to cure the newborns. Key words: Group B streptococcal; Infant, neonatal; Sepsis