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Early Hum Dev. 2009 Oct;85(10 Suppl):S5-7. doi: 10.1016/j.earlhumdev.2009.08.003. Epub 2009 Sep 19.

Group B streptococcal meningitis: cerebrospinal fluid parameters in the era of intrapartum antibiotic prophylaxis.

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1
Department of Pediatrics, Duke University, Durham, North Carolina, USA.

Abstract

OBJECTIVE:

Describe cerebrospinal fluid parameters in infants with culture-proven Group B streptococcal meningitis in the era of intrapartum antibiotic prophylaxis.

STUDY DESIGN:

Cohort study of the first lumbar puncture from 13,495 infants cared for at 150 neonatal intensive care units. We compared cerebrospinal fluid parameters [white blood cell count, red blood cell count, glucose, and protein], demographics, and outcomes between infants with and without Group B streptococcal meningitis.

RESULTS:

We identified 46 infants with Group B streptococcal meningitis. The median cerebrospinal fluid white blood cell count was 271 cells/mm(3) for infants with Group B streptococcal meningitis and 6 cells/mm(3) for infants without meningitis (p=0.0001). Of the infants with Group B streptococcal meningitis, 9/46 (20%) had negative blood cultures. Meningitis complicated 22/145 (15%) of episodes of early-onset Group B streptococcal sepsis and 13/23 (57%) of episodes of late-onset Group B streptococcal sepsis.

CONCLUSIONS:

Group B streptococcal meningitis occurs in the presence of negative blood cultures. In hospitalized infants who undergo a lumbar puncture, Group B streptococcal sepsis is frequently complicated by GBS meningitis.

PMID:
19767158
PMCID:
PMC2783609
DOI:
10.1016/j.earlhumdev.2009.08.003
[Indexed for MEDLINE]
Free PMC Article
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