Outbreak of late-onset Group B Streptococcal disease with serotype Ib in a Neonatal Intensive Care Unit

Background. Hospital outbreaks of invasive group B streptococcus (GBS) infection are rare. There are only a few published reports of late-onset GBS outbreaks in neonatal intensive care units (NICUs). We report here three cases of late-onset GBS in our NICU. Case. Three preterm very low birth weight (VLBW) infants born at 24 –27 weeks gestation developed lateonset GBS sepsis within four weeks. Two asymptomatic GBS carriers were identified in the NICU prior to the outbreak. Tests of maternal rectovaginal GBS colonization were negative in all three cases; as such, vertical transmission was unlikely. All three GBS isolates were capsular serotype 1b, with comparable antibiotic susceptibility profiles. Conclusion. Preterm delivery and VLBW are associated with an increased risk of invasive late-onset GBS infection. This report underscores the ongoing risk of nosocomial transmission of GBS in the NICU.

___

1. Nanduri SA, Petit S, Smelser C, et al. Epidemiology of invasive early-onset and late-onset Group B Streptococcal disease in the United States, 2006 to 2015: Multistate Laboratory and Population-Based Surveillance. JAMA Pediatr 2019; 173: 224-233.

2. Mukhopadhyay S, Puopolo KM. Preventing Neonatal Group B Streptococcus disease: the limits of success. JAMA Pediatr 2019; 173: 219-220.

3. Berardi A, Rossi C, Lugli L, et al. Group B streptococcus late-onset disease: 2003-2010. Pediatrics 2013; 131: e361-e368.

4. Collin SM, Lamb P, Jauneikaite E, et al. Hospital clusters of invasive Group B Streptococcal disease: a systematic review. J Infect 2019; 79: 521-527.

5. Madrid L, Seale AC, Kohli-Lynch M, et al; Infant GBS Disease Investigator Group. Infant Group B Streptococcal disease incidence and serotypes worldwide: systematic review and meta-analyses. Clin Infect Dis 2017; 65(Suppl 65): S160-S172.

6. Al-Maani A, Streitenberger L, Clarke M, et al. Nosocomial transmission of group B streptococci proven by positive environmental culture. Oman Med J 2014; 29: 376-379.

7. Boyer KM, Vogel LC, Gotoff SP, Gadzala CA, Stringer J, Maxted WR. Nosocomial transmission of bacteriophage type 7/11/12 group B streptococci in a special care nursery. Am J Dis Child 1980; 134: 964-966.

8. Barbadoro P, Marigliano A, Savini S, D’Errico MM, Prospero E. Group B Streptococcal sepsis: an old or ongoing threat? Am J Infect Control 2011; 39: e45-e48.

9. Olver WJ, Bond DW, Boswell TC, Watkin SL. Neonatal group B streptococcal disease associated with infected breast milk. Arch Dis Child Fetal Neonatal Ed 2000; 83: F48-F49.

10. Davanzo R, De Cunto A, Travan L, Bacolla G, Creti R, Demarini S. To feed or not to feed? Case presentation and best practice guidance for human milk feeding and group B streptococcus in developed countries. J Hum Lact 2013; 29: 452-457.

11. MacFarquhar JK, Jones TF, Woron AM, et al. Outbreak of late-onset group B Streptococcus in a neonatal intensive care unit. Am J Infect Control 2010; 38: 283-288.

12. Poets CF, Lorenz L. Prevention of bronchopulmonary dysplasia in extremely low gestational age neonates: current evidence. Arch Dis Child Fetal Neonatal Ed 2018 ;103: F285-F291.

13. Jauneikaite E, Kapatai G, Davies F, et al. Serial clustering of late-onset Group B Streptococcal infections in the Neonatal Unit: a genomic reevaluation of causality. Clin Infect Dis 2018; 67: 854- 860.

14. Berardi A, Guidotti I, Creti R, et al. Two overlapping clusters of Group B streptococcus late-onset disease in a Neonatal Intensive Care Unit. Pediatr Infect Dis J 2018; 37: 1160-1164
Turkish Journal of Pediatrics-Cover
  • ISSN: 0041-4301
  • Yayın Aralığı: 6
  • Başlangıç: 1958
  • Yayıncı: Hacettepe Üniversitesi Çocuk Sağlığı Enstitüsü Müdürlüğü
Sayıdaki Diğer Makaleler

Outbreak of late-onset Group B Streptococcal disease with serotype Ib in a Neonatal Intensive Care Unit

Hiroko HORİE-OTA, Kazushige IKEDA

The performance of shear wave elastography on evaluating liver changes in obese and overweight children

Selcen Yaroğlu KAZANCI, Neslihan ÖZKUL SAĞLAM, Sadık Sami HATİPOĞLU, Sema AKSOY, Figen PALABIYIK, Ercan İNCİ

Enablers and barriers for enteral feeding with mother’s own milk in preterm very low birth weight infants in a tertiary care neonatal intensive care unit

Dattatray KULKARNİ, Srinivas MURKİ, Dinesh PAWALE, Soumya JENA, Deepak SHARMA, Venkateshwarlu VARDHELLİ, Venkat KALLEM, Tanveer BASHİR, Vidhyadhara NAİK, Sai KİRAN

Cost of illness of RSV infection in a middle-income tropical country

Diana Guerrero PATINO, Denis SINISTERRA, Jefferson Antonio BUENDIA

Asthma and risk factors in the first 6 years of life in a population-based cohort

Ayşe Şenay ŞAŞİHÜSEYİNOĞLU, Dilek ÖZCAN, Derya Ufuk ALTINTAŞ

Timeliness of postnatal surgery in newborns with open neural tube defects: a single center experience

Mine Kanat PEKTAŞ, Mehmet Gazi BOYACI, Hilal KOYUNCU, Ahmet Afşin KUNDAK, Ayhan PEKTAŞ

IgE mediated food allergy in Turkey: different spectrum, similar outcome

Ayşegül AKARSU

The causes of parental vaccine refusal: results of a survey from Giresun, Turkey

Özlem TERZİ, Elif Nur GÜLEN, Cihad DÜNDAR

Intranasal supernumerary tooth in a child: a case report

Yoon Seok CHOI, Yong-Dae KİM, Chang Hoon BAE, Hyung Gyun NA

Severe isolated sulfide oxidase deficiency with a novel mutation

Meriç ERGENE, Nuriye YARAR, Elif Perihan ÖNCEL, Büşranur ÇAVDARLI, İsmail Zafer ECEVİT, Taner SEZER, Halil İbrahim AYDIN