Group B Streptococcal Sepsis and Meningitis in Neonates: An 11-Year Survey

Objectives: To evaluate the incidence, risk factors, clinical characteristics, morbidity, and mortality of neonates with group B streptococcal (GBS) infection. Methods: Retrospective review of medical charts at Mackay Memorial Hospital, Taipei, Taiwan from 1992 to 2002. Results: During the 11-year study period, 105 infants with GBS infection were found: 59 (56.2%) with early-onset disease (EOD) and 46 (43.8%) with late-onset disease (LOD). The incidence of inborn EOD significantly increased over the past 11 years ranging from 0 per 1000 live births in 1992 to 0.89 per 1000 live births in 2002. Of 59 infants with EOD, 27 (46%) had 1 or more prenatal risk factors, including preterm labor at less than 37 wk of gestation (21; 35.6%), intrapartum maternal fever (5; 8.5%), and premature rupture of membranes by more than 18 h (11; 18.6%). No prenatal risk factors could be identified for the other 32 infants (54%) with EOD. The incidence of short-term neurological sequelae was about 15%. The attributable mortality rates of invasive GBS disease were 10.2% and 2.2% in the EOD and LOD groups, respectively (p=0.133). Conclusions: The incidence of EOD increased over the past 11 years, and GBS disease in neonates resulted in significant mortality and morbidity. Risk-based screening may miss a significant number of early-onset GBS infections. An appropriate policy should be proposed and implemented in Taiwan, based on accurate information about the prevalence and patterns of GBS disease here.