Clinical and laboratory features of Group B Streptococcus meningitis in infants and newborns: study of 848 cases in France from 2001-2014

Abstract

Background

Group B Streptococcus (GBS) disease is the leading cause of neonatal bacterial meningitis despite women receiving an intravenous antibiotic prophylaxis (IAP) during labor. We aimed to describe GBS meningitis in children less than 1 year old in France during 2001-2014.

Methods

Clinical and biological data of GBS meningitis gathered by ACTIV/GPIP and the French National Reference Center for Streptococci were analyzed. The cases were classified by age: 0 to 6 days old (early-onset disease [EOD]), newborns and infants 7 to 89 days old (late-onset disease [LOD]: LOD1, 7–26 days; LOD2, 27–89 days to 3 months) and infants 3 months to 1 year old (infant disease [ID]).

Results

Among 848 GBS meningitis cases from 2001-2014, the incidence of EOD decreased by 63.3% (95% confidence interval [95% CI] [43.9; 80.1], p<0.001) and that of LOD increased by 58.1% 95% CI [39.1; 75.5] p<0.001 (52.9% and 64.3% for LOD1 and LOD2). The mean gestational age (GA) decreased significantly for EOD, LOD1, LOD2 and ID cases, respectively: 38.7, 38.6, 37.3 and 34 weeks. Serotype III accounted for 83.9% of cases, with no significant difference among the four groups or by GA. The frequency of GBS belonging to the clonal complex 17 did not differ among the four groups. Case mortality was 11.4%.

Conclusions

In the era of IAP, we found decreased incidence of early-onset GBS meningitis, but unexpectedly, increased incidence of LOD. These data underline the interest in the development of effective GBS vaccines for pregnant women.