Group B streptococcal meningitis: cerebrospinal fluid parameters in the era of intrapartum antibiotic prophylaxis.
OBJECTIVE
Describe cerebrospinal fluid parameters in infants with culture-proven Group B streptococcal meningitis in the era of intrapartum antibiotic prophylaxis.


METHODS
Cohort study of the first lumbar puncture from 13,495 infants cared for at 150 neonatal intensive care units. We compared cerebrospinal fluid parameters [white blood cell count, red blood cell count, glucose, and protein], demographics, and outcomes between infants with and without Group B streptococcal meningitis.


RESULTS
We identified 46 infants with Group B streptococcal meningitis. The median cerebrospinal fluid white blood cell count was 271 cells/mm(3) for infants with Group B streptococcal meningitis and 6 cells/mm(3) for infants without meningitis (p=0.0001). Of the infants with Group B streptococcal meningitis, 9/46 (20%) had negative blood cultures. Meningitis complicated 22/145 (15%) of episodes of early-onset Group B streptococcal sepsis and 13/23 (57%) of episodes of late-onset Group B streptococcal sepsis.


CONCLUSIONS
Group B streptococcal meningitis occurs in the presence of negative blood cultures. In hospitalized infants who undergo a lumbar puncture, Group B streptococcal sepsis is frequently complicated by GBS meningitis.
Ansong
Annette K
AK
Department of Pediatrics, Duke University, Durham, North Carolina, USA.
Smith
P Brian
PB
Benjamin
Daniel K
DK
Clark
Reese H
RH
Li
Jennifer S
JS
Cotten
C Michael
CM
Mangum
Barry
B
Garges
Harmony P
HP
Benjamin
Daniel K
DK
D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis; D016470:Bacteremia / Q000134:cerebrospinal fluid / Q000150:complications / Q000382:microbiology; D002555:Cerebrospinal Fluid / Q000166:cytology / Q000382:microbiology; D002556:Cerebrospinal Fluid Proteins / Q000032:analysis; D015331:Cohort Studies; D004906:Erythrocyte Count; D005260:Female; D005947:Glucose / Q000134:cerebrospinal fluid; D006801:Humans; D007231:Infant, Newborn; D007958:Leukocyte Count; D008297:Male; D016920:Meningitis, Bacterial / Q000134:cerebrospinal fluid* / Q000150:complications / Q000175:diagnosis / Q000382:microbiology; D013129:Spinal Puncture; D013290:Streptococcal Infections / Q000134:cerebrospinal fluid* / Q000150:complications / Q000175:diagnosis / Q000382:microbiology; D013292:Streptococcus agalactiae / Q000302:isolation & purification
D000900:Anti-Bacterial Agents; D002556:Cerebrospinal Fluid Proteins; D005947:Glucose