1887

Abstract

Introduction:

Late-onset disease with Group B Streptococcus (GBS LOD) remains a significant problem in neonates. Unlike early-onset disease, rates of GBS LOD have not changed with prenatal testing. Effects of GBS LOD can be severe and thus identifying risk factors for severe GBS LOD, such as hypervirulence genes, may help in managing these infants.

Case presentation:

We present a case of a neonate with capsular serotype III GBS sepsis without meningitis that recurred 6 days after a 10-day-treatment period with IV ampicillin. The second episode was characterized by sepsis, neuroinvasion, meningitis and subsequent profound encephalomalacia. The short duration between the two episodes suggested recrudescence rather than reinfection. The GBS isolate was ultimately found to be positive for hypervirulence gene , which encodes for a protein known to mediate meningeal tropism and neuroinvasion.

Conclusion:

positivity may thus potentially serve as an important biomarker for severe and neuroinvasive GBS LOD that can influence treatment decisions.

Keyword(s): GBS , HvgA protein , meningitis , neonate and recurrence
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2016-06-25
2019-10-18
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References

  1. Alhhazmi A. , Hurteau D. , Lovgren M. , Tyrrell G. J. . ( 2014;). Serotype distribution of group B streptococcal isolates collected from cases of invasive disease in Alberta, Canada 2003-2013, abstract 0143. . Proceedings of XIX Lancefield Symposium, Buenos Aires, Argentina, viewed 14 March 2016. http://www.lancefield2014.com/downloads/Lancefield2014_BookOfAbstracts.pdf
  2. Berardi A. , Rossi C. , Lugli L. , Creti R. , Bacchi Reggiani M. L. , Lanari M. , Memo L. , Pedna M. F. , Venturelli C. GBS Prevention Working Group, Emilia-Romagna et al. ( 2013;). Group B streptococcus late-onset disease: 2003-2010. . Pediatrics 131:. [CrossRef] [PubMed]
    [Google Scholar]
  3. Centers for Disease Control and Prevention ( 2010;). Prevention of perinatal group B streptococcal disease. Revised guidelines from CDC. . MMWR 59: 1–32.
    [Google Scholar]
  4. Epalza C. , Goetghebuer T. , Hainaut M. , Prayez F. , Barlow P. , Dediste A. , Marchant A. , Levy J. . ( 2010;). High incidence of invasive group B streptococcal infections in HIV-exposed uninfected infants. . Pediatrics 126:. [CrossRef] [PubMed]
    [Google Scholar]
  5. Filleron A. , Lombard F. , Jacquot A. , Jumas-Bilak E. , Rodiere M. , Cambonie G. , Marchandin H. . ( 2014;). Group B streptococci in milk and late neonatal infections: an analysis of cases in the literature. . Arch Dis Child Fetal Neonatal Ed 99: F41–F47.[CrossRef]
    [Google Scholar]
  6. Garges H. P. , Moody M. A. , Cotten C. M. , Smith P. B. , Tiffany K. F. , Lenfestey R. , Li J. S. , Fowler V. G. , Benjamin D. K. . ( 2006;). Neonatal meningitis: what is the correlation among cerebrospinal fluid cultures, blood cultures, and cerebrospinal fluid parameters?. Pediatrics 117: 1094–1100. [CrossRef] [PubMed]
    [Google Scholar]
  7. Haug R. H. . ( 1972;). Type classification of the group B streptococci by means of Lancefield's precipitin method. Classification of strains of bovine and human origin; isolated during the year 1971 in Norway. . Nord Vet Med 24: 631–638.[PubMed]
    [Google Scholar]
  8. Krause J. C. , Ghandil P. , Chrabieh M. , Casanova J. L. , Picard C. , Puel A. , Creech C. B. . ( 2009;). Very late-onset group B streptococcus meningitis, sepsis, and systemic shigellosis due to interleukin-1 receptor-associated kinase-4 deficiency. . Clin Infect Dis 49: 1393–1396. [CrossRef] [PubMed]
    [Google Scholar]
  9. Lin F. Y. , Weisman L. E. , Troendle J. , Adams K. . ( 2003;). Prematurity is the major risk factor for late-onset group B streptococcus disease. . J Infect Dis 188: 267– 271. [CrossRef] [PubMed]
    [Google Scholar]
  10. Lancefield R. C. , McCarty M. , Everly W. N. . ( 1975;). Multiple mouse-protective antibodies directed against group B streptococci. Special reference to antibodies effective against protein antigens. . J Exp Med 142: 165–244.[PubMed] [CrossRef]
    [Google Scholar]
  11. Mercer B. M. , Miodovnik M. , Thurnau G. R. , Goldenberg R. L. , Das A. F. , Ramsey R. D. , Rabello Y. A. , Meis P. J. , Moawad A. H. et al. ( 1997;). Antibiotic therapy for reduction of infant morbidity after preterm premature rupture of the membranes. A randomized controlled trial. National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network . . JAMA 278: 989–995.[PubMed] [CrossRef]
    [Google Scholar]
  12. Tazi A. , Disson O. , Bellais S. , Bouaboud A. , Dmytruk N. , Dramsi S. , Mistou M. Y. , Khun H. , Mechler C. , other authors . ( 2010;). The surface protein HvgA mediates group B streptococcus hypervirulence and meningeal tropism in neonates. . J Exp Med 207: 2313–2322. [CrossRef] [PubMed]
    [Google Scholar]
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