Probable early-onset Group B streptococcal neonatal sepsis: a serious clinical condition related to intrauterine infection

Xavier Carbonell -Estrany ^1*, Josep Figueras -Aloy ¹, Salvador Salcedo -Abizanda ² and Manuel de la Rosa Fraile ³

¹ Hospital Clinic, Barcelona, Spain
² Hospital Vall d'Hebron, Barcelona, Spain
³ Hospital Virgen de las Nieves, Granada, Spain

^* To whom correspondence should be addressed. E-mail: xcarbo{at}clinic.ub.es.

Accepted 9 August 2007

Abstract

Aim of the study:The estimated incidence of true early-onset group B streptococcal (GBS) neonatal infection is based on positive GBS blood or cerebrospinal fluid (CSF) culture results, but the real burden of disease is underestimated due to the high incidence of culture-negative sepsis possibly due to antibiotic administration to the mother.

Methods:This study examined the rate of probable early-onset GBS neonatal sepsis in a multicenter longitudinal prospective surveillance of 107,021 deliveries.

Results:The rates of culture-proven and probable early-onset GBS sepsis were 0.39 and 0.47 per 1000 live births, respectively. Of great concern was the finding of a 3 deaths related to the infection in the probable early-onset GBS sepsis group.

Conclusions:The use of chemoprophylaxis in GBS colonized pregnant women especially when it is incomplete, may not be sufficient to prevent clinical neonatal infection, but might inhibit the growth of GBS in blood and CSF cultures. In assessing the effectiveness of GBS prophylaxis, it is advisable to consider the incidence of both culture positive and probable culture negative GBS neonatal infection.

Keywords: antibiotic prophylaxis/utilization, infant/newborn, neonatal sepsis/diagnosis, neonatal sepsis/epidemiology, streptococcal Infections/epidemiology

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