Synchronous recurrence of group B streptococcal late-onset sepsis in twins.
Group B Streptococcus (GBS) remains the leading cause of neonatal sepsis and meningitis in industrialized countries. Whereas the use of intrapartum antibiotic prophylaxis has led to a significant decline in early-onset sepsis, the incidence of late-onset sepsis has remained unchanged. Whether late-onset sepsis usually originates from established mucocutaneous GBS colonization of the infant or whether it results from an acute exogenous GBS infection remains controversial. Here we report on twins who both twice developed GBS sepsis in a strikingly parallel fashion, with both instances originating from a single hypervirulent GBS clone. Factored together, the presentation as cervical soft tissue infection in both cases, the synchronicity of the episodes, and the detection of GBS DNA in breast milk all strongly suggest an enteral mode of transmission with a short incubation period.
Centers for Pediatrics and Adolescent Medicine and Chronic Immunodeficiency, University Medical Center, Freiburg, Freiburg, Germany;
Roland
R
Elling
Centers for Pediatrics and Adolescent Medicine and.
Markus
M
Hufnagel
Respiratory and Vaccine Preventable Bacteria Reference Unit, Microbiology Services Division, Health Protection Agency, Colindale, London, United Kingdom; and.
Aruni
A
de Zoysa
Centers for Pediatrics and Adolescent Medicine and Clinic and Policlinic for Pediatrics and Adolescent Medicine, University Hospital Carl Gustav Carus, Technical University Dresden, Dresden, Germany.
Fabian
F
Lander
Centers for Pediatrics and Adolescent Medicine and.
Katharina
K
Zumstein
Centers for Pediatrics and Adolescent Medicine and.
Marcus
M
Krueger
Centers for Pediatrics and Adolescent Medicine and Chronic Immunodeficiency, University Medical Center, Freiburg, Freiburg, Germany; philipp.henneke@uniklinik-freiburg.de.
Philipp
P
Henneke
D004750:Enteral Nutrition; D006801:Humans; D007235:Infant, Premature, Diseases / Q000175:diagnosis* / Q000382:microbiology; D008895:Milk, Human / Q000382:microbiology; D009333:Neck; D012008:Recurrence; D018805:Sepsis / Q000175:diagnosis* / Q000382:microbiology / Q000635:transmission; D018461:Soft Tissue Infections / Q000175:diagnosis* / Q000382:microbiology / Q000635:transmission; D013290:Streptococcal Infections / Q000175:diagnosis* / Q000382:microbiology / Q000635:transmission; D013292:Streptococcus agalactiae / Q000472:pathogenicity; D014429:Twins, Dizygotic; D014774:Virulence
S agalactiae; breast milk; group B streptococcus; late-onset sepsis; sepsis