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Antibiotic elimination of group-B streptococci in urine in prevention of preterm labour.

The presence of group-B streptococci in the urine of pregnant women seems to be associated with preterm labour. Urine samples from 4122 women at 27-31 weeks' gestation were examined for bacteria. Group-B streptococci were found in the urine of 69 women. In a double-blind, controlled study these patients were given either penicillin (10(6) IU three times daily for 6 days; 37 patients) or placebo (32 patients). The rates of primary rupture of the membranes (11% v 53%; p less than 0.001) and preterm labour (5.4% v 38%; p less than 0.002) were significantly lower in the penicillin group than in th

Scrotal ecchymosis: sign of intraperitoneal hemorrhage in the newborn.

Ecchymosis of the scrotum and lower abdominal wall occurred in four newborn boys. All were anemic. Three had coagulation abnormalities and evidence of sepsis. In two, group B streptococcal septicemia was documented. Intraperitoneal hemorrhage from a ruptured subcapsular hematoma of the liver was the source of blood in the scrotum in three, and most probably in the fourth as well. Two infants died in spite of antibiotics, vigorous blood replacement, including exchange transfusion, and desperation laparotomies for continued intraperitoneal hemorrhage. Newborns with scrotal ecchymosis should be e

Infections in Hospitalized Cancer Patients.

Cancer patients are at an increased risk of developing infections that are primarily treatment-driven but may also be malignancy-driven. While cancer treatments such as chemotherapy, radiotherapy, and surgery have been known to improve malignancy morbidity and mortality, they also have the potential to weaken immune defenses and induce periods of severe cytopenia. These adverse effects pave the way for opportunistic infections to complicate a hospitalized cancer patient's clinical course. Understanding the risk each patient inherently has for developing a bacterial, fungal, or viral infection

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… Invasive disease due to beta-hemolytic streptococci, specifically Streptococcus agalactiae ( S. agalactiae ), is also common in cancer patients [ 21 ]. … Streptococcus agalactiae infection in cancer patients: a five-year study. Eur J Clin Microbiol Infect Dis. 2016;35(6):927–933. doi: 10.1007/s10096-016-2617-9. 31. Phares CR, Lynfield R, Farley MM, Mohle-Boetani J, Harrison LH, Petit S, Craig AS. et al. …

How can we reduce neonatal sepsis after universal group B streptococcus screening?

BACKGROUND: Group B Streptococcus (GBS) infection remains a leading cause of newborn morbidity and mortality. The study aimed to determine the adherence rate to the universal screening policy a decade after its introduction. Secondly, whether the timing of antibiotics given in GBS carriers reduces the incidence of neonatal sepsis. METHODS: Delivery records at Hong Kong Baptist Hospital in 2022 were examined to retrieve antenatal and intrapartum details regarding maternal GBS carrier status, previous maternal GBS carrier status, antibiotic treatment, timing of treatment, neonatal condition at

Microbiological and clinical characteristics of Group B Streptococcus isolates causing materno-neonatal infections: high prevalence of CC17/PI-1 and PI-2b sublineage in neonatal infections.

PURPOSE: Group B Streptococcus (GBS) is one of the major pathogens in severe materno-neonatal infections. We aimed to describe the clinical and molecular characteristics of GBS isolates causing infections in 45 maternal and 50 neonatal subjects, collected from eight healthcare centres in mainland China over the period 2010- 2017. METHODOLOGY: The phenotypic and genotypic features of the GBS isolates, including capsular polysaccharide (cps) serotypes, pilus island (PI) genes and antibiotic resistance profiles and genes, were characterized by both conventional and molecular methods. The clonal

Identification of CiaR Regulated Genes That Promote Group B Streptococcal Virulence and Interaction with Brain Endothelial Cells.

Group B Streptococcus (GBS) is a major causative agent of neonatal meningitis due to its ability to efficiently cross the blood-brain barrier (BBB) and enter the central nervous system (CNS). It has been demonstrated that GBS can invade human brain microvascular endothelial cells (hBMEC), a primary component of the BBB; however, the mechanism of intracellular survival and trafficking is unclear. We previously identified a two component regulatory system, CiaR/H, which promotes GBS intracellular survival in hBMEC. Here we show that a GBS strain deficient in the response regulator, CiaR, localiz

The burden of early-onset sepsis in Emilia-Romagna (Italy): a 4-year, population-based study.

OBJECTIVE: To provide the first Italian data on pathogens causing early-onset sepsis (EOS) and their antimicrobial susceptibility, after the successfully prevention of Group B streptococcus (GBS) EOS. METHODS: Retrospective area-based cohort study from Emilia-Romagna (Italy). Cases of EOS registered (from 2009 to 2012) in all gestational age neonates were reviewed. RESULTS: Live births (LB) numbered 146 682. Ninety neonates had EOS and 12 died (incidence rates of 0.61 and 0.08/1000 LB, respectively). EOS and mortality were the highest among neonates with a birth weight <1000 g (20.37/1000 LB

Survey of American obstetricians regarding group B streptococcus: opinions and practice patterns.

OBJECTIVE: The objective of the study was to evaluate attitudes and practice patterns of obstetricians related to screening for group B streptococcal colonization and providing intrapartum antibiotic prophylaxis against early-onset neonatal infections with group B streptococcus. STUDY DESIGN: We mailed a survey to 546 members of the American College of Obstetricians and Gynecologists, including members of the Collaborative Ambulatory Research Network and non-Collaborative Ambulatory Research Network members. Stratified random selection was used to generate samples from both of these groups.

[Clinical manifestations and treatment of early-onset neonatal sepsis: a Chinese-French comparison].

OBJECTIVE: To realize the difference between China and France in the clinical manifestations, diagnosis and treatment of early-onset neonatal sepsis (EONS) and to provide basis to improve the level of our hospital in diagnosing and treating this disease. METHOD: Data of 146 cases of EONS were retrospectively analyzed. All data were collected from our hospital and a French hospital. Bacterial spectrum, clinical manifestations, use of antibacterial drugs, occurrence of recording and screening of perinatal risk factors were compared between the two hospitals. RESULT: The most common pathogenic

Early onset neonatal sepsis: the burden of group B Streptococcal and E. coli disease continues.

BACKGROUND: Guidelines for prevention of group B streptococcal (GBS) infection have successfully reduced early onset (EO) GBS disease. Study results suggest that Escherichia coli is an important EO pathogen. OBJECTIVE: To determine EO infection rates, pathogens, morbidity, and mortality in a national network of neonatal centers. METHODS: Infants with EO infection were identified by prospective surveillance at Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Network centers. Infection was defined by positive culture results for blood and cerebrospinal f

The burden of invasive early-onset neonatal sepsis in the United States, 2005-2008.

BACKGROUND: Sepsis in the first 3 days of life is a leading cause of morbidity and mortality among infants. Group B Streptococcus (GBS), historically the primary cause of early-onset sepsis (EOS), has declined through widespread use of intrapartum chemoprophylaxis. We estimated the national burden of invasive EOS cases and deaths in the era of GBS prevention. METHODS: Population-based surveillance for invasive EOS was conducted in 4 of the Centers for Disease Control and Prevention's Active Bacterial Core surveillance sites from 2005 to 2008. We calculated incidence using state and national l

Inflammatory and oxidative parameters in cord blood as diagnostic of early-onset neonatal sepsis: a case-control study.

OBJECTIVE: To determine whether levels of interleukin (IL)-6, IL-10, and oxidative parameters in umbilical cord blood could contribute as an indicator of neonatal sepsis in recognized high-risk neonates. DESIGN: Prospective, case-control study. SETTING: Neonatal intensive care unit. SUBJECTS: One hundred twenty consecutive preterm neonates who had at least one other risk factor for early-onset neonatal sepsis. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Umbilical cord blood samples were obtained for the determination of IL-6, IL-10, thiobarbituric acid reactive substances (TBARS),

No increase in rates of early-onset neonatal sepsis by antibiotic-resistant group B Streptococcus in the era of intrapartum antibiotic prophylaxis.

OBJECTIVE: The aim of this study was to assess the rate of early-onset neonatal sepsis by antibiotic-resistant group B Streptococcus. STUDY DESIGN: The time-trend study was conducted at a tertiary care center over the following periods: no protocol for group B Streptococcus prophylaxis (1990 to 1992), risk-based protocol (1993 to 1996), and screening-based protocol (1997 to 2002). RESULTS: A total of 120,952 neonates were born with 118 cases of group B Streptococcus early-onset neonatal sepsis. The rate of group B Streptococcus early-onset neonatal sepsis decreased significantly (from 2.0 to

[Decreasing incidence of perinatal group B streptococcal disease (Barcelona 1994-2002). Relation with hospital prevention policies].

INTRODUCTION: To analyze the incidence of perinatal sepsis due to group B streptococcus (GBS) as related to compliance with recommendations for its prevention issued by the Catalan Societies for Obstetrics, for Pediatrics, and for Infectious Diseases and Clinical Microbiology in 1997. METHODS: The study was conducted from 1994 to 2001 in 10 Barcelona-area hospitals, where 157,848 live infants were born. RESULTS: GBS disease was diagnosed in 129 neonates. Incidence decreased by 86.1% over the study period, from 1.92 cases per 1000 live births in 1994 to 0.26 per 1000 in 2001 (p < 0.001). Chan

Screening strategies for group B streptococcus in the third trimester of pregnancy.

PURPOSE: To identify the best screening protocol to prevent neonatal group B streptococcal (GBS) sepsis through literature review. DATA SOURCES: Selected research articles, texts, and Internet sources. CONCLUSIONS: Centers for Disease Control and Prevention (CDC), American Academy of Pediatrics (AAP), American College of Obstetricians and Gynecologists (ACOG), and American College of Nurse Midwives (ACNM) have issued guidelines describing methods to identify pregnant women at risk of intrapartum transmission of GBS to their babies. Studies have been conducted to discover the superiority of o

[Risk of neonatal Streptococcus B infection].

23 cases of contamination with streptococcus group B have been seen after premature rupture of the membranes. Mothers and fetuses have been affected. The systematic study of swabs or liquor or cervical discharge carried out on the mother since the time her membranes had ruptured show that in 74 per cent of cases studied contamination existed within the first 24 hours. Giving antibiotics to the mother before delivery gave very variable results. These multiple tests, before and around the time of birth, made it possible to detect the children at risk of infection and to start antibiotic therapy

The increasing burden of group B Streptococcus from 2013 to 2023: a retrospective cohort study in Beijing, China.

Group B Streptococcus (GBS) is a leading pathogen responsible for fatal infections in newborns primarily due to vertical transmission from colonized mothers. Cases of invasive GBS infections in adults have also increased and attracted attention recently. To comprehensively understand the evolving burden of vaginal GBS carriage in pregnant and non-pregnant women, as well as the trends in invasive GBS diseases and antibiotic resistance in China, we conducted a retrospective study using data from a large tertiary hospital in Beijing from 2013 to 2023. Over the past decade, improvements in GBS scr

Group B Streptococcus serotypes associated with different clinical syndromes: Asymptomatic carriage in pregnant women, intrauterine fetal death, and early onset disease in the newborn.

OBJECTIVES: To study Group B Streptococcus (GBS) isolates associated with different clinical syndromes: asymptomatic carriage in pregnant women, intrauterine fetal death (IUFD), and early onset disease (EOD) in the newborn. METHODS: GBS isolates were collected from asymptomatic pregnant women admitted for labor, IUFD cases, and neonates with EOD. Serotypes and antibiotic susceptibilities were determined. Multilocus sequence typing (MLST) was performed to assess genetic epidemiology. RESULTS: GBS carriage rate was 26.1% (280/1074). The dominant serotype among asymptomatic pregnant women was V

Group B streptococcus colonization and HIV in pregnancy: A cohort study in Nigeria.

BACKGROUND: Group B streptococcus (GBS) is a leading cause of maternal and neonatal infectious morbidity. HIV is prevalent among pregnant women in Nigeria. AIM: To determine the rates of anogenital GBS colonization in our institution and compare GBS colonization rates between HIV positive and negative pregnant women. METHODS: A cross-sectional comparative study was conducted over 6 months. Patients were separated according to their HIV status: positive and negative. GBS colonization was assessed by vaginal and anal swabs collected at 35-37 weeks of gestation and cultured in Todd-Hewitt broth