CLINICAL SPECTRUM OF NEONATAL GROUP B STREPTOCOCCAL DISEASE

Abstract

Neonatal disease caused by group B beta hemolytic streptococci (GBS) has received considerable attention in recent years. A 5 year review of neonatal GBS disease was made to determine if an increase in incidence occurred and to define the spectrum of disease caused by this organism. 71 infants with GBS disease were seen from 1969 through 1973: 25 infants (35%) were encountered in 1973 alone. The incidence (per 1000 births) of GBS disease decreased from 1969 through 1972 and then significantly increased in 1973: 1.6 (‘69), 1.3 (‘70),1.O (‘71), 0.6 (‘72) and 2.4 (‘73). In contrast, the incidence of neonatal infection by Escherichia coli was unchanged during this period. Mortality rate was greater if septicemia or meningitis occurred within the first 48 hours of life (35%) compared to disease presenting later (15%).Previous reports have emphasized the septicemic and meningitic forms of neonatal GBS disease. In this study 12 of 71 infants (17%) manifested unusual or previously unrecognized forms of GBS infection: asymptomatic bacteremia in 4 infants, septic arthritis in 3 infants and osteomyelitis, ethmoiditis with orbital cellulitis, pneumonia with empyema, facial cellulitis, and conjunctivitis in 1 infant each. Familiarity with the diverse clinical presentations of neonatal GBS disease should increase prompt recognition and treatment as well as institution of appropriate epidemiologic controls to prevent spread of infection to personnel and other babies.