Group B streptococcal septicemia of the newb... Health Article

Definition

Group B streptococcal septicemia is a severe bacterial infection that affects newborn infants.

See also: Neonatal sepsis

Causes, incidence, and risk factors

Group B streptococcal septicemia is caused by the bacteria Streptococcus agalactiae. This bacteria is commonly found in the human gastrointestinal, reproductive, and urinary tracts.

If the bacteria travels from the mother's bloodstream through the placenta the infant can become infected. The infant may also become infected if the mother's water breaks (membranes rupture) as the infant passes through the birth canal.

The infant may also become infected after delivery.

The disease may be seen from birth to 6 days of life (generally in the first 24 hours) or in children age 7 days to 3 months. Most cases occur in babies around 1 month old.

Group B streptococcus was once responsible for about 75% of sepsis infections in infants. However, the rate of this condition has dropped since methods to screen and treat pregnant women at risk have been established.

The following increase an infant's risk for group B streptococcal septicemia:

• Mother who has a fever during labor
• Mother who has group B streptococcus in her gastrointestinal, reproductive, or urinary tracts
• Rupture of membranes ("water breaks") more than 18 hours before baby is delivered
• Prematurity
• Prior history of giving birth to a baby with this condition

Symptoms

Parents should watch for any of the following symptoms when their child is less than 3 months old, particularly in the first 6 weeks. The early stages of the disease can produce subtle symptoms.

Symptoms in the infant may include:

• Anxiety or stress
• Blue appearance (cyanosis)
• Breathing difficulties such as:
  • Grunting
  • Flaring of the nostrils
  • Rapid breathing
  • Short periods without breathing
• Coma
• Irregular heart rate - may be fast or extremely slow
• Irregular heartbeat
• Lethargy
• Poor feeding
• Shock
• Unstable body temperature (low or high)

Signs and tests

Tests that may be done to diagnose this condition in a newborn include:

• Blood clotting tests - Prothrombin time (PT) and Partial thromboplastin time (PTT)
• Blood culture
• Blood gases
• Complete blood count
• CSF culture
• Urine culture
• X-ray of the chest

Treatment

Treatment may involve one or more of the following:

• Antibiotics given through a vein
• Fluids given through a vein
• Medicines to reverse shock
• Medicines or procedures to correct blood clotting problems
• Oxygen therapy
• Breathing help

A complex therapy called extra-corporeal membrane oxygenation (ECMO) may be used in very severe cases.