Neonatal infections by Streptococcus agalactiae

OBJECTIVES: The objectives of the study were to evaluate: 1) The incidence and characteristics of neonatal infections by S. agalactiae in the Hospital Sant Joan de Deu of Barcelona, 2) the efficiency of a microbiological control during the third quarter of pregnancy in order to detect colonization by this microorganism; and 3) the efficiency of intrapartum prophylaxis. MATERIAL AND METHODS: Neonatal infections that took place between May 1991 and December 1994 have been studied. Children were born from women controlled in our hospital (7.772 pregnant women) or from women who delivered in other health centers. RESULTS: Nineteen newborn children with an invasive infection and four asymptomatic bacteriemias were diagnosed and treated during the above mentioned period of time. Early forms of the illness were sepsis (eight cases), meningitis (four cases) and arthritis (one case), whereas late forms were comprised of four cases of meningitis and two of arthritis. Three of the neonates died (mortality rate of 15.7%) and two of them developed neurologic sequelae. CONCLUSIONS: The microbiological control during pregnancy in order to detect S. agalactiae carriers, as well as intrapartum antibiotic prophylaxis contributes to reduce the number of this sort of infections. Negative results of cultures carried out during the third quarter of pregnancy do not exclude a carrier state at delivery, therefore, so posterior controls are necessary until the end of pregnancy.