Relationship of Neonatal Pneumonia to Maternal Urinary and Neonatal Isolates of Group B Streptococci

Liston, Thomas E.; Harris, Robert S.; Foshee, Stuart; Null, Donald M.

doi:10.1097/00007611-197911000-00019

Cited by 21 publications

(10 citation statements)

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“…Procedures during pregnancy, such as cervical cerclage and amniocentesis, which disrupt the amniotic cavity, may also increase the rates of intra-amniotic infection and subsequent neonatal sepsis (14). During labor, maternal risk factors include prolonged rupture of membranes, fever, vaginal colonization with group B streptococcus (GBS), and GBS bacteriuria (15)(16)(17)(18)(19)(20). A history of a previous infant with GBS infection is another identified maternal risk factor in subsequent pregnancies (21)(22)(23).…”

Section: Epidemiology and Pathophysiologymentioning

confidence: 99%

Early-Onset Neonatal Sepsis

et al. 2014

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SUMMARY Early-onset sepsis remains a common and serious problem for neonates, especially preterm infants. Group B streptococcus (GBS) is the most common etiologic agent, while Escherichia coli is the most common cause of mortality. Current efforts toward maternal intrapartum antimicrobial prophylaxis have significantly reduced the rates of GBS disease but have been associated with increased rates of Gram-negative infections, especially among very-low-birth-weight infants. The diagnosis of neonatal sepsis is based on a combination of clinical presentation; the use of nonspecific markers, including C-reactive protein and procalcitonin (where available); blood cultures; and the use of molecular methods, including PCR. Cytokines, including interleukin 6 (IL-6), interleukin 8 (IL-8), gamma interferon (IFN-γ), and tumor necrosis factor alpha (TNF-α), and cell surface antigens, including soluble intercellular adhesion molecule (sICAM) and CD64, are also being increasingly examined for use as nonspecific screening measures for neonatal sepsis. Viruses, in particular enteroviruses, parechoviruses, and herpes simplex virus (HSV), should be considered in the differential diagnosis. Empirical treatment should be based on local patterns of antimicrobial resistance but typically consists of the use of ampicillin and gentamicin, or ampicillin and cefotaxime if meningitis is suspected, until the etiologic agent has been identified. Current research is focused primarily on development of vaccines against GBS.

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Section: Epidemiology and Pathophysiologymentioning

confidence: 99%

Early-Onset Neonatal Sepsis

et al. 2014

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“…The aetiology in these cases is often obscure, although GBS might be suspected for several reasons. Infants born to mothers harbouring GBS in the urine have a high incidence of pneumonia [18]. A relation between abnormal fetal heart rate [FHR) recordings as well as fetal blood pH values below 7.20, frequently early signs of pneumonia, and maternal carriage of GBS has been demonstrated [9].…”

Section: Introductionmentioning

confidence: 99%

The significance of group B streptococci in neonatal pneumonia

Christensen

Dahlander

et al. 1983

Eur J Pediatr

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Thirty-eight infants admitted to a neonatal intensive care unit because of pneumonia (14 patients) and pulmonary maladaption syndrome (PMA) (24 patients) were included in the study. Samples of potentially pathogenic, facultatively anaerobic bacteria were taken from the external ear, blood, throat, nasopharynx, umbilicus and gastric aspirates of the children, and from urethra and cervix of the mothers. Group B streptococci (GBS) and Escherichia coli were the only potentially pathogenic bacteria isolated from the infants. Out of 14 infants with pneumonia 11 (79%) harboured one of these bacteria, in contrast to 3 out of 24 (13%) with PMA (P less than 0.001). GBS was found in 8/14 infants with pneumonia and in 1/24 infants with PMA (P less than 0.001). The respective frequencies for Escherichia coli were 3/14 and 2/24 (not significant). The infant and/or the mother in 10/14 pneumonia cases harboured GBS, in contrast to 4/24 pairs in the PMA group (P less than 0.001). The levels of antibodies against GBS in sera of mothers to infants with pneumonia did not differ from the antibody levels in control sera (parturient GBS-carriers giving birth to healthy infants). The results gave evidence for an important manifestation of neonatal GBS-infection: pneumonia without septicemia. The incidence of the disease is estimated to be 1:25 parturient GBS-carriers. Finally, maternal fever, gestational age above 42 weeks, more severe respiratory difficulties and the occurrence of severe changes in fetal heart rate during the first stage of labour were found to be typical characteristics of pneumonia, as compared to PMA.

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“…Liston et al (12) reported a high incidence of neonatal pneumonia in infants born to mothers with GBS-positive urine cultures. Furthermore, Wood and Dillon (9) described 2 cases of intrauterine fetal death, and 1 neonatal GBS septicaemia among the children born to 14 women with GBS bacteriuria.…”

Section: Discussionmentioning

confidence: 99%

Asymptomatic Bacteriuria during Pregnancy with Special Reference to Group B Streptococci

Persson

Christensen

et al. 1985

Scandinavian Journal of Infectious Diseases

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The relationship between significant bacteriuria (SB), i.e. 2 subsequent voided urine specimens with greater than or equal to 10(5) colony forming units (CFU)/ml, and the occurrence of bacteria in the urinary bladder detected by bladder punction, was investigated in asymptomatic pregnant women. From 30 (70%) of the 43 women with SB studied, bacteria were isolated from the urinary bladder. The same bacteria were found in the bladders of all 21 women with Escherichia coli, the one with Klebsiella pneumoniae, and the one with Staphylococcus saprophyticus in midstream urine. Six of 10 patients with group B streptococci (GBS), 1 of 4 patients with Streptococcus faecalis, and none of 5 patients with Staphylococcus epidermidis in voided specimens had bacteria in the aspirated urine. Serotype III was isolated from 8/10 patients with SB caused by GBS. One child born to a woman with GBS SB but no bacteria in the urinary bladder, got early onset septicaemia. The poor predictive value of SB with GBS, S. faecalis and S. epidermidis necessitates the increased use of bladder puncture for diagnosis of true asymptomatic bacteriuria (AB), i.e. AB with bacteria in the urinary bladder. SB with GBS even without bacteria in the urinary bladder, may constitute a threat to the baby's health.

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Relationship of Neonatal Pneumonia to Maternal Urinary and Neonatal Isolates of Group B Streptococci

Cited by 21 publications

References 0 publications

Early-Onset Neonatal Sepsis

Early-Onset Neonatal Sepsis

The significance of group B streptococci in neonatal pneumonia

Asymptomatic Bacteriuria during Pregnancy with Special Reference to Group B Streptococci

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