[Severe late-onset group B streptococcal infection. A case report].
BACKGROUND
Group B Streptococcus (GBS) is a well-known cause of neonatal pneumonia, sepsis and meningitis. Peripartal antibiotic prophylaxis for early-onset GBS infection is in routine use since the beginning of the last decade, but strategies for effective prevention of late-onset GBS infections are still lacking.


METHODS
Few hours after discharge from a non-local maternity ward a 3-week-old boy was admitted to our hospital because of GBS meningitis with necrotizing encephalomalacia. Maternal mastitis, not a disease of the baby, had led to the first admission.


CONCLUSIONS
Case history and negative maternal swabs and cultures for GBS led to the hypothesis of nosocomial infection. Screening and risk based peripartal antibiotic prophylaxis, better monitoring and improved therapeutic modalities have reduced the incidence and mortality of early-onset GBS infections, but peripartal prophylaxis failed to influence late-onset GBS infections. Up to 40 % of infants with late-onset meningitis develop neurological sequelae. Maternal vaccination with multivalent conjugate vaccines against GBS is a new strategy which may lead to passive protection of the infant. Further studies to examine the efficacy of vaccines are in progress.
Haase
Roland
R
Zentrum für Kinderheilkunde, Universitätsklinik und Poliklinik für Kinder- und Jugendmedizin, Martin-Luther-Universität Halle-Wittenberg. roland.haase@medizin.uni-halle.de
Nagel
Frank
F
Hirsch
Wolfgang
W
Sitka
Uwe
U
D000900:Anti-Bacterial Agents; D001921:Brain / Q000473:pathology; D001929:Brain Edema / Q000175:diagnosis; D003428:Cross Infection / Q000175:diagnosis* / Q000188:drug therapy; D003560:Cysts / Q000175:diagnosis; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D004453:Echoencephalography; D004678:Encephalomalacia / Q000175:diagnosis* / Q000188:drug therapy; D005500:Follow-Up Studies; D005625:Frontal Lobe / Q000473:pathology; D006801:Humans; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging; D008297:Male; D016920:Meningitis, Bacterial / Q000175:diagnosis* / Q000188:drug therapy; D008826:Microbial Sensitivity Tests; D013290:Streptococcal Infections / Q000175:diagnosis* / Q000188:drug therapy; D013292:Streptococcus agalactiae
D000900:Anti-Bacterial Agents