Abstract
Clinical pictures of 274 group B streptococcus (GBS) neonatal sepsis and meningitis gathered from 50 hospitals in Japan were analysed. Postnatal ages of their clinical onset were distributed more or less equally all through neonatal period except an apparent cluster on the day of birth, which made it difficult to divide these cases into two, early and late onset types. There were three distinct clinical pictures:
AMNIOTIC INFECTION TYPE which manifests symptoms at birth with asphyxia and respiratory distress, and which has history suggesting antenatal infection. RAPID PROGRESS SEPSIS TYPE which presents sudden onset of septic shock and rapid deterioration in an infant who has been clinical well. SLOW PROGRESS MENINGITIS TYPE which has symptoms of fever and/or not-doing well for 24 hours or longer prior to the definite manifestation of meningitis. The latter two types could occur on any postnatal ages.
Vaginal cultures of 2800 pregnant women using Baker's original method revealed 12.1% positive rate for GBS. Serotype Ic which is predominant (45%) in carrier mother is responsible for only 10% of clinical cases, while serotypes III and Ia which are resposible for 73% and 11% of clinical cases are seen only 25% and 0.5% in carrier mother respectively. These findings will suggest the difference of pathogenicity among serotypes and will partly explain their marked different clinical pictures.
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Nishida, H., Kadoi, N. NEW CLASSIFICATION OF NEONATAL GBS INFECTION—ANALYSIS OF 274 CLINICAL CASES—. Pediatr Res 18 (Suppl 4), 337 (1984). https://doi.org/10.1203/00006450-198404001-01463
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DOI: https://doi.org/10.1203/00006450-198404001-01463