Group B strep infection of newborns persists

Even though the US Centers for Disease Control and Prevention has recommended since 2002 that expectant mothers be screened for carriage of group B strep, a few cases of early-onset group B streptococcal disease still occur in infants each year in the US, new research shows.

Group B strep used to be a leading cause of serious infection in newborns. It has a 10-20 percent mortality rate, and leaves many survivors with brain damage.

Most of the cases that still occur involve infants whose mothers screened negative for colonization with the microbe, according to a report in the medical journal Pediatrics.

Dr. Karen M. Puopolo and colleagues, from Brigham and Women’s Hospital in Boston, assessed the occurrence of neonatal group B streptococcal disease at their institution between 1997 and 2003. In particular, they were interested in determining the reasons for continued disease in this era of maternal screening.

Among the 67,260 live-born infants, 25 had early-onset group B streptococcal disease, the researchers report.

Seventeen cases, with one fatality, were noted among term infants and eight cases with three fatalities were seen among preterm infants.

In the term-infant group, 14 of the 17 mothers had screened negative for group B strep colonization. In the preterm infant group, just three of the eight mothers were positive for GBS at delivery.

Adequate preventative antibiotic treatment was given during delivery in just 1 of these 25 cases.

The authors of the report say prompt antibiotic treatment “remains imperative” for women with signs and symptoms of birth canal infection “regardless of their group B strep-screening results,” along with evaluation of well-appearing infants who may have been exposed to infection during delivery.

SOURCE: Pediatrics, May 2005.

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