Streptococcus group B is often the causal agent in maternofetal infections occurring early. The prevention of fatal fulminant forms is much controversial.
Population and methods: A retrospective multicentric study (10 maternity wards, 5 years, 96.243 live births) was conducted. All cases of early (<48 th) infection due to Streptococcus group B were collected and divided into two groups for comparison: group 1: infant death, and group 2: surviving infants requiring ventilatory assistance for > or = 12 hours. The aim of this study was to determine the incidence of fatal infections and to ascertain he clinical features and laboratory data correlated with death.
Results: The incidence of fatal early maternofetal infection due to Streptococcus group B (group 1) was 14 cases in 96,243 live births (0.14%) or 1 case in 7,143 live births. All newborns who died were symptomatic at 8 hours of life. The factors significantly correlated with death were: lack of antibiotics per partum, which did not [correction of no] altogether prevent severe forms (2/14 deaths and 14/28 survivals had had antibiotic per partum); prematurity; impaired adaptation to birth, early clinical signs and sudden aggravation; lack of an inflammatory syndrome at first work-up; a chest X-ray suggesting hyalin membrane disease; and major non-infectious associated disease.
Conclusion: These findings underscore the importance of antibiotic prophylaxy per partum and the need for immediate paediatric care in case of risk factors.