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At least 433 records · Page 24Linked to original sources
PubMed2006

Early neonatal streptococcal infection.

OBJECTIVE: To determine the incidence of early onset Group B Streptococcal (GBS) infection in infants born over a two year period and to determine the outcome of sepsis evaluation in infants born to mothers with GBS colonization. METHODS: The charts of infants born to mothers with GBS colonization were reviewed for details of sepsis evaluation and management. The microbiology records were used to identify proven cases of GBS septicemia and meningitis in neonates born during the study period. RESULTS: Out of a total of 4636 live births in 2 years, there was one infant with culture-proven GBS septicemia, an incidence of 0.2 per 1000 live births. During the study period 83 infants were born to mothers who were known to have GBS carriage at the time of delivery. 73 out of these 83 infants (88%) had sepsis evaluation and received empirical parenteral penicillin for at least 5 days. There were no cases of blood culture-proven GBS sepsis among these 83 infants. However, there were 2 cases of probable sepsis giving an attack rate of 2.4%. All the three infants with definite or probable sepsis were preterm; there were no deaths among these affected infants. CONCLUSION: The overall incidence of early onset GBS sepsis was found to be low when compared to previous reported studies. The strategy of sepsis evaluation and management was found to be effective in preventing death and definite GBS septicemia in infants born to GBS colonized mothers.

Humans↗
PubMed2000

The influence of intrapartum antibiotics on the clinical spectrum of early-onset group B streptococcal infection in term infants.

OBJECTIVE: The use of intrapartum antibiotics to prevent early-onset group B streptococcal (EOGBS) infection has left pediatricians in a quandary about the appropriate evaluation and treatment of infants at risk for this infection. The aim of this study was to determine whether intrapartum antibiotic prophylaxis changed the constellation and timing of onset of clinical signs of group B streptococcal (GBS) infection in term infants. METHODOLOGY: We conducted a retrospective chart review of infants who had EOGBS infection and were born in Southern California Kaiser Permanente Hospitals from 1988 through 1996. Objective criteria were used to ascertain maternal risk of infection, intrapartum antibiotic prophylaxis, and onset of clinical signs of infection. RESULTS: Three hundred nineteen infants with EOGBS sepsis, bacteremia, or clinically suspected infection were identified from a population of 277 912 live births. Of the 172 term infants with culture-positive infection who had clinical signs of infection, 95% exhibited them in the first 24 hours of life. All of the infants exposed to intrapartum antibiotics became ill within the first 24 hours of life. CONCLUSIONS: Exposure to antibiotics during labor did not change the clinical spectrum of disease or the onset of clinical signs of infection within 24 hours of birth for term infants with EOGBS infection. A 48-hour stay is not required to monitor asymptomatic term infants exposed to intrapartum antibiotics for onset of GBS infection.

Antibiotic Prophylaxis↗
PubMed1988

Group A streptococcal infection in children younger than three years of age.

We evaluated 758 sick children younger than 3 years of age for Group A beta-hemolytic streptococcal (GABHS) upper respiratory infection (URI) to determine the usual clinical presentation of the disease in this age group, indications for culture and the optimal site(s) from which to isolate the organism. GABHS infection was documented in 35 subjects (4.6%). The classic presentation (as proposed in the 1940s) of GABHS URI in children younger than 3 years of age was not confirmed by this study. In 32 of the GABHS cases there were pharyngitis, common cold symptoms or both, and these were associated with acute otitis media 10 times and with otitis media with effusion 3 times. Clinical impetigo was associated with GABHS URI (4 of 32 cases). GABHS URI would not have been documented in 6 of 32 cases if cultures of the anterior nares had not been performed. Children between 18 and 36 months of age were more likely to have GABHS disease than were younger children. Hoarseness and vomiting occurred less frequently in children younger than 36 months with GABHS infection than in those of that age who had non-beta-hemolytic streptococcal illnesses. A history of two or more siblings at home or a family member with a recent streptococcal infection and the presence of irritability, a reddened throat or palate or uvular edema were each associated with GABHS URI. We concluded that sick children between 18 and 36 months of age with a reddened throat should have cultures taken of the throat and anterior nares for GABHS.(ABSTRACT TRUNCATED AT 250 WORDS)

Bacteriological Techniques↗
PubMed1998

[Specimen culture from all children in a day care center because of an outbreak of streptococcal infection].

In an outbreak of recurrent group A streptococcal (GAS) pharyngotonsillitis between January and February 1997 at a Swedish preschool, involving 58% (11/19) of the children and several family members, clinical examination showed few of the children to manifest signs and symptoms of tonsillitis. However, throat specimens yielded GAS growth of the same T-type in 42% (8/19) of the children and in 30% (6/20) of family members, but in none of the staff. Strict hygiene, appropriate antibiotic treatment of all culture-positive individuals irrespective of symptoms, and non-attendance at the preschool during the first two days of treatment promptly terminated the outbreak and there were no cases of recurrence.

Anti-Bacterial Agents↗
PubMedDate not supplied

Changes and changing concepts in the biology of group A streptococci and in the epidemiology of streptococcal infections.

Concepts of the cellular structure of group A streptococci have been modified by the recognition of surface fimbriae and by problems with the older view of a layered arrangement of cell wall components. Evidence of genetic drift of serologic types and of some increase in the prevalence of erythromycin-resistant strains has appeared. A curiois bimodal age distribution for streptococcal pharyngitis and an increase in the prevalence of non-group A strains has been detected. Despite repeated challenges, the value of throat cultures for confirming the possibility of streptococcal pharyngitis remains firmly established; throat cultures are superior to saliva cultures, which more frequently detect non-group A streptococci. Difficulties in detecting subclinical steptococcal infections and in defining streptococcal infection in children in endemic situations (particularly in separating true streptococcal infection from carriage of streptococci in individuals whose illness is due to some other agent) continue to present problems to clinicians and epidemiologists. The value of school culture surveys and of treatment of asymptomatic family contacts of cases remains uncertain. A 20% bacteriologic failure rate has been reported after intramuscular treatment with benzathine penicillin, but no in vitro evidence of resistance to penicillin has appeared. No adequate explanations are available for the decline in the problem of rheumatic fever in industrialized countries, for its increased recognition in tropical countries, for the failure of rheumatic fever to occur after streptococcal pyoderma, or for the emergence of group B Streptococcus as a predominant bacterial pathogen in newborn infants.

Adolescent↗
PubMed1983

Perinatal group B streptococcal infections.

Predisposing factors and clinical presentations associated with early-onset group B streptococcal (GBS) infections in 60 infants were reviewed. Over a three-year period, the incidence of these infections in The Royal Women's Hospital, Melbourne, was 2.0 per 1000 births. The clinical presentation ranged from fulminating sepsis to asymptomatic bacteraemia. In some cases, there was evidence of intrauterine fetal infection, despite intact membranes and a lack of clinical evidence of maternal infection. However, the over-all incidence of fever, before and after delivery, among the mothers of these babies was high. Early, or prophylactic, antibiotic therapy was generally associated with a favourable outcome. None of the infants who died from GBS infections had received antibiotic therapy before the onset of symptoms. The value of routine antenatal screening for vaginal carriage of group B streptococci, and the place of antibiotic prophylaxis, or immunoprophylaxis, are not yet established. However, prophylactic antibiotic therapy in mothers and babies considered to be at risk from GBS infection is recommended.

Anti-Bacterial Agents↗
PubMed1992

Community-acquired invasive group A beta-hemolytic streptococcal infections in Zuni Indians.

BACKGROUND: Outbreaks of invasive group A beta-hemolytic streptococcal (GABS) infections have recently been reported. We observed a high incidence of invasive GABS disease among Native Americans at a small rural community hospital between 1982 and 1991. METHODS: A retrospective chart review was performed, and all cases of invasive GABS disease were studied for their clinical features. RESULTS: Sixteen cases of invasive GABS infection were identified during the 10-year study period. The rate of invasive GABS infection was 13.3 cases per 100,000 population per year. Mortality was 25%. Nearly half of the patients presented with systemic signs of sepsis without any obvious source of infection. CONCLUSIONS: Our experience documents a high rate of invasive GABS infections in a defined Native American population. To determine whether this population has a unique susceptibility to GABS disease requires further study.

Adult↗
PubMed2002

Late-onset group B streptococcal infection in identical twins: insight to disease pathogenesis.

Late-onset group B streptococcal (GBS) infection affecting identical twins is described. Although exhibiting similar signs and symptoms at presentation, twin A suffered fulminant fatal meningitis while twin B recovered completely. The GBS isolates proved to be genetically identical and possessed equivalent abilities to invade and injure cells of the human blood-brain barrier in vitro. Clinical variables associated with the adverse outcome in twin A were longer duration of fever prior to antibiotics and the development of neutropenia. The case histories and experimental data are reviewed to underscore key features of GBS disease pathogenesis.

Age of Onset↗