Late and very late onset group B Streptococcus sepsis: One and the same?

Joseph B. Cantey, Courtney Baldridge, Rachel Jamison, Leticia A. Shanley

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background: This study aimed to describe the clinical characteristics of group B Streptococcus (GBS) sepsis in infants aged 4-90 days [late onset (LO)] compared to infants >90 days of age [very late onset (VLO)]. Methods: Microbiology records at Children's Medical Center Dallas were screened. Demographic, clinical, and outcome data were collected for infants with GBS recovered from blood or cerebrospinal fluid culture from January 1, 2006 to July 1, 2012. Results: Totally 48 infants were identified (42 LO, 6 VLO). Infants with VLO sepsis had lower median gestational age (28.5 vs. 39 weeks gestation, P<0.001) and longer median nursery admissions (8.8 vs. 0.5 weeks, P=0.004). When gestational age was controlled for, there were no differences in clinical presentation, intensive care unit admission, length of stay, neurodevelopmental outcome, and mortality. Infants with VLO sepsis were more likely to receive vancomycin (83% vs. 33%, P=0.02) or third-generation cephalosporins (83% vs. 24%, P=0.009), and more likely to continue on those agents even after GBS was identified. Conclusions: Infants with VLO sepsis had lower gestational ages and longer nursery stays than infants with LO sepsis. Beyond age at presentation, there were no significant differences in clinical presentations, hospital course, frequency of neurodevelopmental sequelae, and mortality in infants presenting with LO vs. VLO GBS sepsis. Infants with VLO sepsis were more likely to receive empiric broad spectrum antimicrobials and more likely to continue receiving broad therapy even following GBS identification.

Original languageEnglish (US)
Pages (from-to)24-28
Number of pages5
JournalWorld Journal of Pediatrics
Volume10
Issue number1
DOIs
StatePublished - Feb 2014

Fingerprint

Streptococcus agalactiae
Sepsis
Gestational Age
Nurseries
Infant Mortality
Cephalosporins
Vancomycin
Microbiology
Intensive Care Units
Cerebrospinal Fluid
Length of Stay
Demography
Pregnancy
Mortality

Keywords

  • group B Streptococcus
  • infant
  • meningitis
  • sepsis

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Late and very late onset group B Streptococcus sepsis : One and the same? / Cantey, Joseph B.; Baldridge, Courtney; Jamison, Rachel; Shanley, Leticia A.

In: World Journal of Pediatrics, Vol. 10, No. 1, 02.2014, p. 24-28.

Research output: Contribution to journalArticle

Cantey, Joseph B. ; Baldridge, Courtney ; Jamison, Rachel ; Shanley, Leticia A. / Late and very late onset group B Streptococcus sepsis : One and the same?. In: World Journal of Pediatrics. 2014 ; Vol. 10, No. 1. pp. 24-28.
@article{61104b4c7b544e28a67f8b16838ae5c3,
title = "Late and very late onset group B Streptococcus sepsis: One and the same?",
abstract = "Background: This study aimed to describe the clinical characteristics of group B Streptococcus (GBS) sepsis in infants aged 4-90 days [late onset (LO)] compared to infants >90 days of age [very late onset (VLO)]. Methods: Microbiology records at Children's Medical Center Dallas were screened. Demographic, clinical, and outcome data were collected for infants with GBS recovered from blood or cerebrospinal fluid culture from January 1, 2006 to July 1, 2012. Results: Totally 48 infants were identified (42 LO, 6 VLO). Infants with VLO sepsis had lower median gestational age (28.5 vs. 39 weeks gestation, P<0.001) and longer median nursery admissions (8.8 vs. 0.5 weeks, P=0.004). When gestational age was controlled for, there were no differences in clinical presentation, intensive care unit admission, length of stay, neurodevelopmental outcome, and mortality. Infants with VLO sepsis were more likely to receive vancomycin (83{\%} vs. 33{\%}, P=0.02) or third-generation cephalosporins (83{\%} vs. 24{\%}, P=0.009), and more likely to continue on those agents even after GBS was identified. Conclusions: Infants with VLO sepsis had lower gestational ages and longer nursery stays than infants with LO sepsis. Beyond age at presentation, there were no significant differences in clinical presentations, hospital course, frequency of neurodevelopmental sequelae, and mortality in infants presenting with LO vs. VLO GBS sepsis. Infants with VLO sepsis were more likely to receive empiric broad spectrum antimicrobials and more likely to continue receiving broad therapy even following GBS identification.",
keywords = "group B Streptococcus, infant, meningitis, sepsis",
author = "Cantey, {Joseph B.} and Courtney Baldridge and Rachel Jamison and Shanley, {Leticia A.}",
year = "2014",
month = "2",
doi = "10.1007/s12519-014-0450-8",
language = "English (US)",
volume = "10",
pages = "24--28",
journal = "World Journal of Pediatrics",
issn = "1708-8569",
publisher = "Institute of Pediatrics of Zhejiang University",
number = "1",

}

TY - JOUR

T1 - Late and very late onset group B Streptococcus sepsis

T2 - One and the same?

AU - Cantey, Joseph B.

AU - Baldridge, Courtney

AU - Jamison, Rachel

AU - Shanley, Leticia A.

PY - 2014/2

Y1 - 2014/2

N2 - Background: This study aimed to describe the clinical characteristics of group B Streptococcus (GBS) sepsis in infants aged 4-90 days [late onset (LO)] compared to infants >90 days of age [very late onset (VLO)]. Methods: Microbiology records at Children's Medical Center Dallas were screened. Demographic, clinical, and outcome data were collected for infants with GBS recovered from blood or cerebrospinal fluid culture from January 1, 2006 to July 1, 2012. Results: Totally 48 infants were identified (42 LO, 6 VLO). Infants with VLO sepsis had lower median gestational age (28.5 vs. 39 weeks gestation, P<0.001) and longer median nursery admissions (8.8 vs. 0.5 weeks, P=0.004). When gestational age was controlled for, there were no differences in clinical presentation, intensive care unit admission, length of stay, neurodevelopmental outcome, and mortality. Infants with VLO sepsis were more likely to receive vancomycin (83% vs. 33%, P=0.02) or third-generation cephalosporins (83% vs. 24%, P=0.009), and more likely to continue on those agents even after GBS was identified. Conclusions: Infants with VLO sepsis had lower gestational ages and longer nursery stays than infants with LO sepsis. Beyond age at presentation, there were no significant differences in clinical presentations, hospital course, frequency of neurodevelopmental sequelae, and mortality in infants presenting with LO vs. VLO GBS sepsis. Infants with VLO sepsis were more likely to receive empiric broad spectrum antimicrobials and more likely to continue receiving broad therapy even following GBS identification.

AB - Background: This study aimed to describe the clinical characteristics of group B Streptococcus (GBS) sepsis in infants aged 4-90 days [late onset (LO)] compared to infants >90 days of age [very late onset (VLO)]. Methods: Microbiology records at Children's Medical Center Dallas were screened. Demographic, clinical, and outcome data were collected for infants with GBS recovered from blood or cerebrospinal fluid culture from January 1, 2006 to July 1, 2012. Results: Totally 48 infants were identified (42 LO, 6 VLO). Infants with VLO sepsis had lower median gestational age (28.5 vs. 39 weeks gestation, P<0.001) and longer median nursery admissions (8.8 vs. 0.5 weeks, P=0.004). When gestational age was controlled for, there were no differences in clinical presentation, intensive care unit admission, length of stay, neurodevelopmental outcome, and mortality. Infants with VLO sepsis were more likely to receive vancomycin (83% vs. 33%, P=0.02) or third-generation cephalosporins (83% vs. 24%, P=0.009), and more likely to continue on those agents even after GBS was identified. Conclusions: Infants with VLO sepsis had lower gestational ages and longer nursery stays than infants with LO sepsis. Beyond age at presentation, there were no significant differences in clinical presentations, hospital course, frequency of neurodevelopmental sequelae, and mortality in infants presenting with LO vs. VLO GBS sepsis. Infants with VLO sepsis were more likely to receive empiric broad spectrum antimicrobials and more likely to continue receiving broad therapy even following GBS identification.

KW - group B Streptococcus

KW - infant

KW - meningitis

KW - sepsis

UR - http://www.scopus.com/inward/record.url?scp=84893499039&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84893499039&partnerID=8YFLogxK

U2 - 10.1007/s12519-014-0450-8

DO - 10.1007/s12519-014-0450-8

M3 - Article

C2 - 24464660

AN - SCOPUS:84893499039

VL - 10

SP - 24

EP - 28

JO - World Journal of Pediatrics

JF - World Journal of Pediatrics

SN - 1708-8569

IS - 1

ER -