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Original ArticleOpen Access
Neonatal Group B Streptococcal Infection : Incidence and Clinical Manifestation in Siriraj Hospital
Yossuck P 
,
Preedisripipat K
,
Preedisripipat K PANITAN YOSSUCK, M.D.*,
KANCHANA PREEDISRIPIPAT, M.D.*
From 1996 to 2001, nineteen episodes of bacteremia due to group B Streptococci (GBS)
were diagnosed in Siriraj Hospital, Mahidol University. The incidence of early onset group B strepto-
coccal disease (EOD) was 0.27 cases/1,000 live births in 1996, and decreased to 0.10 cases/1,000
live births in 2001. The incidence of the late onset disease (LOD) was 0.05 cases/1,000 in 1996,
and there has been none since 1998. All of the infants were inborn. Low birth weight was found
in 53 per cent of the infants. Fifty-eight per cent of infants were male. Forty-seven per cent of
the infants were born prematurely. None of the mothers had antenatal GBS screening. Only one
mother received one dose of intrapartum antibiotic prophylaxis. No risk factor could be identified
in 72 per cent of the mothers. EOD accounted for 79 per cent of all infants with GBS infections,
with a mortality rate of 40 per cent. All of them died within the first 72 hours of life. Most
EOD infants developed disease manifestations within 12 hours of life. Most common clinical
manifestations were respiratory distress (74%), temperature instability (68%), cyanosis (63%), hypo-
tension (42%) and lethargy (42%). Only one infant with EOD had meningitis. There were two
infants in the LOD group; one of whom had cellulitis, and the other had meningitis. Neutropenia
was noted in 42 per cent of all infants. Radiographic studies suggested a diffuse reticulogranular
pattern or ground glass appearance in 38 per cent. The chest X-ray was interpreted as normal in
25 per cent of the infants. In conclusion, the incidence of GBS infection in newborn infants in
Thailand is still very low but with a very high mortality. Prematurity accounts for almost half of
the cases. Even though antepartum screening with intrapartum antibiotic chemoprophylaxis has
been recommended in developed counties, its benefit and cost needs to be further investigated in
Thailand.
Key word : GBS, Group B Strectococci, Sepsis, Incidence
YOSSUCK P
&
PREEDISRIPIPAT
KANCHANA PREEDISRIPIPAT, M.D.*
From 1996 to 2001, nineteen episodes of bacteremia due to group B Streptococci (GBS)
were diagnosed in Siriraj Hospital, Mahidol University. The incidence of early onset group B strepto-
coccal disease (EOD) was 0.27 cases/1,000 live births in 1996, and decreased to 0.10 cases/1,000
live births in 2001. The incidence of the late onset disease (LOD) was 0.05 cases/1,000 in 1996,
and there has been none since 1998. All of the infants were inborn. Low birth weight was found
in 53 per cent of the infants. Fifty-eight per cent of infants were male. Forty-seven per cent of
the infants were born prematurely. None of the mothers had antenatal GBS screening. Only one
mother received one dose of intrapartum antibiotic prophylaxis. No risk factor could be identified
in 72 per cent of the mothers. EOD accounted for 79 per cent of all infants with GBS infections,
with a mortality rate of 40 per cent. All of them died within the first 72 hours of life. Most
EOD infants developed disease manifestations within 12 hours of life. Most common clinical
manifestations were respiratory distress (74%), temperature instability (68%), cyanosis (63%), hypo-
tension (42%) and lethargy (42%). Only one infant with EOD had meningitis. There were two
infants in the LOD group; one of whom had cellulitis, and the other had meningitis. Neutropenia
was noted in 42 per cent of all infants. Radiographic studies suggested a diffuse reticulogranular
pattern or ground glass appearance in 38 per cent. The chest X-ray was interpreted as normal in
25 per cent of the infants. In conclusion, the incidence of GBS infection in newborn infants in
Thailand is still very low but with a very high mortality. Prematurity accounts for almost half of
the cases. Even though antepartum screening with intrapartum antibiotic chemoprophylaxis has
been recommended in developed counties, its benefit and cost needs to be further investigated in
Thailand.
Key word : GBS, Group B Strectococci, Sepsis, Incidence
YOSSUCK P
&
PREEDISRIPIPAT
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