Late Onset Streptococcus agalactiae Meningitis following Early Onset Septicemia: A Preventable Disease?

Kam Lun Hon,Pak Long Ko,King Hang Chan,King Woon So,Alexander K C Leung

doi:10.1155/2017/8418105

Abstract

We report a neonate who presented with early onset Streptococcus agalactiae or group B streptococcus (GBS) septicemia within 24 hours of birth. After discharge at day 14, she went on to develop late onset GBS meningitis at 36 days of age. The infant was treated with intravenous antibiotics on both occasions and eventually discharged home with no apparent sequelae. We address issues associated with GBS infection in infancy including the demographics, risk factors, and the risk of late onset GBS meningitis following an early onset GBS infection. The major source of GBS in early onset GBS disease is maternal birth canal GBS colonization. On the other hand, nosocomial cross-infection is an important source of GBS in late onset disease. Penicillin remains the current treatment of choice for GBS infection. Given the rapid onset and progression within hours of birth and lack of an effective solution for preventing late onset GBS, administration of an effective GBS vaccine in pregnancy could provide a sensible and cost-effective solution in all settings.

Highlights

Neonatal infection with Streptococcus agalactiae or group B streptococcus (GBS) is serious, potentially preventable, and imminently treatable [1,2,3,4,5,6,7]
As GBS immunization is not currently available, known maternal GBS carriers with infants who had early onset GBS disease should be informed about risks of late onset GBS disease on discharge
These infants should be immediately assessed, should there be any suspicion of late onset GBS infection

Summary

Introduction

Neonatal infection with Streptococcus agalactiae or group B streptococcus (GBS) is serious, potentially preventable, and imminently treatable [1,2,3,4,5,6,7]. Understanding the sources and mechanisms of infection is crucial in the prevention and treatment to reduce neonatal morbidity and mortality of this disease [1,2,3, 10,11,12] This case illustrates that adequate antibiotic treatment for early onset. As GBS immunization is not currently available, known maternal GBS carriers with infants who had early onset GBS disease should be informed about risks of late onset GBS disease on discharge. These infants should be immediately assessed, should there be any suspicion of late onset GBS infection

Case Report

Findings

Discussion