Neonatal group B streptococcal infection at the University Hospital of the West Indies, Jamaica: a 10-year experience.
OBJECTIVE
To describe the incidence, clinical presentation and outcome of neonatal group B streptococcal (GBS) infection at the University Hospital of the West Indies (UHWI).


METHODS
A 10-year retrospective review of all inborn neonates admitted to the neonatal unit of UHWI with GBS infection between 1 January 1991 and 31 December 2000 was conducted. Differences in maternal and neonatal characteristics between early- and late-onset disease (EOD, LOD) were determined.


RESULTS
There were 32,029 live births and 29 neonates were admitted for GBS infection, an incidence of 0.91/1000 live births (95% CI 0.58-1.23/1000). Twenty-one (72%) neonates had EOD, a rate of 0.66/1000 live births (95% CI 0.38-0.94/1000) and eight (28%) had LOD, a rate of 0.23/1000 (95% CI 0.08-0.42/1000). Seventeen of the 21 (81%) cases of EOD occurred within the 1st 24 hours of life. The most common clinical diagnosis was septicaemia (17, 61%), followed by pneumonia (8, 28%) and meningitis (3, 11%). All five (100%) babies whose mothers' membranes were ruptured for >18 hours had EOD. The babies of all six (100%) women with intrapartum pyrexia went on to have EOD. A greater proportion of babies (63%) with LOD were preterm and of low birthweight. The most common presenting symptom was respiratory distress which occurred more frequently in neonates with EOD, p=0.006. One neonate died, giving a case fatality rate of 3.6%.


CONCLUSIONS
Although the incidence of GBS infection is relatively low at UHWI, further reduction in the incidence might be achieved by implementation of measures to prevent perinatal transmission.
Trotman
H
H
Department of Obstetrics, Gynaecology and Child Health, University of the West Indies, Mona, Jamaica. helen.trotmanedwards@uwimona.edu.jm
Bell
Y
Y
D000328:Adult; D017668:Age of Onset; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000453:epidemiology; D005334:Fever / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D007563:Jamaica / Q000453:epidemiology; D008297:Male; D008581:Meningitis / Q000453:epidemiology; D009035:Mothers; D011014:Pneumonia / Q000453:epidemiology; D011247:Pregnancy; D012189:Retrospective Studies; D018805:Sepsis / Q000453:epidemiology; D013290:Streptococcal Infections / Q000097:blood / Q000134:cerebrospinal fluid / Q000453:epidemiology*; D013292:Streptococcus agalactiae / Q000302:isolation & purification*