P-1144. Low prevalence of neonatal sepsis due to Streptococcus agalactiae in two large Mexican NICUs: multicenter retrospective study from 2021-2023

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Abstract Background Group B Streptococcus (GBS), or S. agalactiae, is reported as a leading cause of neonatal sepsis in several regions including the United States. Although in recent years its incidence has shown a steady decline, current treatment guidelines still consider it a predominant cause of neonatal sepsis. Its prevalence varies according to geographical and racial factors; however, information regarding the epidemiology and clinical presentation of neonatal GBS infection in Mexico is scarce. Methods Retrospective multicenter study conducted in the NICUs of the two pediatric reference hospitals in NL, Mexico. Data of all newborns ≤28 days (d) diagnosed with blood culture-proven GBS infection from 2021-2023 were collected. Maternal premature rupture of membranes (PROM) was defined as >12h. GBS infection was classified as early (< 7 d) and late-onset (≥7 d). LBWIs were defined as newborns < 2500 g and very LBWI (VLBWI) as < 1500 g at birth, respectively. Clinical scenarios were classified as sepsis, pneumonia and meningitis. Sepsis was classified as early (≤3 d) and late-onset ( >3 d). Descriptive statistical analyses were performed to determine frequencies. Results A total of 928 positive blood cultures were included. 28 blood cultures (3%) from 27 patients were positive for GBS. Maternal PROM was documented in 11.1%. Most patients were term infants (77%) and 92.6% of the cases were early-onset. The most common presentation was sepsis (92.6%). One patient (3.7%) had pneumonia and one (3.7%) had meningitis due to GBS. Low mortality was documented (3.7%). Table 1 shows clinical characteristics of patients with GBS infection. As expected, all isolates were susceptible to Ampicillin. Conclusion We report a low prevalence of culture-proven GBS infection (3%) in two large Mexican NICUs during the studied period. This is consistent with previous single-center reports from Mexico, which date back to more than two decades. Although the international epidemiology and treatment guidelines consider GBS a predominant cause of neonatal sepsis, its frequency in Mexico remains low. The vast majority of cases were early-onset infections, and the most common clinical presentation was sepsis, which is consistent with global epidemiology. Disclosures All Authors: No reported disclosures