Incidence Of Group B Streptococcus Infection Research Articles

Streptococcus agalactiae meningitis presenting with cerebral infarction in an adult patient: Clinical case and review

Bacterial meningitis is an inflammation of the meninges associated with the invasion of bacteria. The etiologic agents vary by age group. Bacterial meningitis due to group B streptococcus (GBS) is common for the neonatal period but is deemed to be rare in adult patients. Since 2000, more than two-thirds of all cases occur in adults, which is becoming a growing problem worldwide. We present a rare case of GBS meningitis presented with cerebral infarction in an adult patient and briefly review the etiology and incidence of GBS infections in adults. There is an increasing incidence of cases in elderly patients, particularly in those with more medical comorbidities. Cerebral infarction as an adverse effect in bacterial meningitis is both a sign of severity and a predictor of a poor clinical outcome with a high mortality rate. Early recognition of the infection, a search for deep-seated infection, and early antimicrobial therapy are vital moments for successful management of the GBS disease.

Group B streptococcal sacroilitis in an illicit drug abuser

Introduction: Group B Streptococcus (GBS) is a usual neonatal pathogen, but the incidence in adult populations has risen recently. Pregnant women are at a higher risk of developing this infection. Invasive GBS is increasingly being recognized as one of the major pathogens in periprosthetic joint infections, but native joint infections are still rare. Serious invasive GBS disease can occur in adults with significant underlying medical conditions such as human immunodeficiency virus and active intravenous illicit drug use, as seen in our patient. Case presentation: We report the case of a 31‐year‐old man who presented with pain and decreased mobility of the right hip joint. He was human immunodeficiency virus positive and was actively abusing illicit drugs via the intravenous route. He was directly injecting into the groin, which contributed to setting up a focus of infection in the immediate vicinity, resulting in the development of bacteraemia and seeding the region by haematogenous spread. Magnetic resonance imaging revealed severe right‐sided sacroilitis and an iliopsoas abscess from direct contiguous spread. Culture of blood and pus from the iliopsoas abscess revealed GBS. The iliopsoas abscess was drained, and the patient was started on penicillin G therapy. The patient’s symptoms improved dramatically after just 2 weeks of therapy. Conclusion: We present this unusual clinical setting and site of infection, to highlight the increasing incidence of GBS native joint infections in susceptible non‐pregnant adults. The focus of GBS infection in this patient was unique and atypical, probably representing a contiguous spread of infection from the site of illicit drug injections. With an increasing incidence of GBS infections in non‐pregnant adults, it must be considered among the differential diagnoses of patients presenting with septic arthritis. Early recognition of GBS septic arthritis and prompt institution of treatment might prevent long‐term and often debilitating sequelae.

Are we using too many antibiotics during pregnancy?

Are we using too many antibiotics during pregnancy?

The impact of group B Streptococcus prophylaxis on early onset neonatal infections

To determine if changes have occurred in the causative pathogens and/or antibiotic susceptibility profiles in early onset neonatal infections since initiation of group B Streptococcus (GBS) prophylaxis and to determine risk factors for ampicillin/penicillin resistant microorganisms. Data on 220 infants with positive blood, urine, or cerebrospinal fluid cultures for bacteria or fungi at ≤seven days of age from 1990-2007 were examined and divided into three epochs, based on intrapartum antibiotic prophylactic (IAP) practices. Pathogens and antibiotic resistance were compared among epochs. A significant decrease in the incidence of GBS infections occurred over time, with no change in the incidence of other pathogens or the emergence of antibiotic resistance, including the very low-birthweight population. In regression analysis, ampicillin resistance was associated with male gender (OR 3.096). No emergence of antibiotic resistant pathogens was found following IAP use. Changing microorganisms and increasing antibiotic resistance found in prior studies are likely multifactorial. Further study is needed to continue to reduce the rates of common early onset pathogens.

Pattern and etiology of culture-proven early-onset neonatal sepsis: a five-year prospective study

To investigate the incidence of early-onset neonatal sepsis and identify the main pathogens over a 5-year period in Kuwait. Blood samples were collected from all infants with any clinical or laboratory feature suggestive of sepsis, at the main maternity hospital in Kuwait. Cases of early-onset neonatal infection were defined as culture of a single potentially pathogenic organism from blood or cerebrospinal fluid from infants younger than 7 days of age, in association with clinical or laboratory findings consistent with infection. The overall incidence of early-onset neonatal infection was 2.7 (95% confidence interval (CI) 2.3-3.2) episodes per 1000 live-births. The case-fatality was 13.1% (95% CI 8.6-18.9%). Group B Streptococcus (GBS) accounted for 17.6% of infections among infants younger than 7 days (incidence 0.48 per 1000 live-births), but 38.1% of infections in the first 2 days of life. Neither the incidence of early-onset infection by GBS nor by Escherichia coli changed significantly over the study period. Although the incidence of GBS infections was relatively low, GBS accounted for most early-onset infections. Intrapartum antibiotic prophylaxis against GBS should be strengthened. There was no evidence to suggest that early-onset infection due to non-GBS organisms such E. coli has increased in the last 5 years.

A survey of the incidence of neonatal sepsis by group B Streptococcus during a decade in a Brazilian maternity hospital.

Group B Streptococcus (GBS) is the main etiological agent of neonatal sepsis in developed countries, however there is no detailed information on its incidence in Brazil. We registered the incidence and lethality of GBS infection in a Brazilian private maternity hospital from April 1991 to March 2000. Maternal risk factors contributing to neonatal infections were also scored. The rate of infection was determined by checking for GBS in the blood and liquor of symptomatic neonates within 72 hours of birth. Sepsis and/or early onset meningitis were diagnosed in 43 neonates (32 cases in blood, 1in liquor and 10 in blood and liquor). The overall incidence was 0.39 per thousand neonates and remained quite constant throughout the period, ranging from 0.25-0.63. Septic shock occurred in 33 neonates within 1 to 36 hours of birth (mean 15 hours). Among those patients, 26 (60%) died between the 5th and the 85th hour after birth. Maternal risk factors, according to CDC criteria, included: gestational age below 37 weeks in 26 cases (60%), amniorrhexis equal or superior to 18 hours in 7 cases (16%), and maternal temperature equal or superior to 38(o)C in 4 cases (9%). None of the mothers had received prophylactic antibiotics during labor nor were urine, rectal or vaginal swabs screened for GBS. Although the incidence of GBS infection in the population in this study was lower than that found in developed countries, its rate of mortality was higher. The death rate could be reduced through recognition of the risk factors and prophylactic antibiotics during labor.

Prevalence of antibodies against group B streptococcal capsular polysaccharides in healthy Chinese neonates.

Prevalence of antibodies against group B streptococcal capsular polysaccharides in healthy Chinese neonates.