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.
Department of Obstetrics, Gynaecology and Child Health, University of the West Indies, Mona, Jamaica. helen.trotmanedwards@uwimona.edu.jm
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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*