The Clinical Features Of Neonatal Late-onset Group B Streptococcal Infection

Objective:To investigate the clinical features of neonatal late-onset group B streptococcal(GBS)infection to develop the knowledge of treatment and prognosis Method;To collected the clinical data of 17 cases diagnosed as neonatal late-onset GBS infection in Wuhan children’s hospital from October 2018 to October 2021,then match 18 patients diagnosed as early-onset GBS infection in the same period,The initial symptom,infection,drug susceptibility results,risk factors,family factors and immune factors,the rate and duration of antibiotics treatment,length of hospital stay,treatment costs,neurological complications were compared in two groups Results1.The initial symptoms of neonatal late-onset GBS infection were fever and feeding intolerance,Compared with early-onset GBS infection were moaning and tachypneic(P <0.05).2.The pneumonia of neonatal late-onset GBS infection were 0,GBS meningitis and sepsis were 88.2%(15/17)and 64.7%(11/17)respectively.In neonatal early-onset GBS infection group,Pneumonia accounted for 27.8%(5/18),sepsis and meningitis were 77.8%(14/18)and 44.4%(8/18)respectively.3.Late-onset GBS were sensitive to penicillin,vancomycin,ceftriaxone,linezolid,meropenem,and were resistanced to clindamycin and tetracycline.Neonatal early-onset GBS were sensitive to penicillin,vancomycin,ceftriaxone,linezolid meropenem,and resistanced to clindamycin and tetracycline at 93.7% and 100%,respectively.4.The duration of antibiotic treatment were(24.7 ± 14.2)day in neonatal late-onset GBS infection and(23.1 + 13.9)days in neonatal early-onset GBS infection with no statistical significance.(P >0.05).5.There were no statistical significance(P > 0.05)in preterm birth,immunoglobulin G reduces intrapartum feer and mother,GBS infection or colonize between neonatal late-onset early-onset GBS groups,the Caregivers were more likely to suffer from infection in late-onset GBS group than early-onset GBS infection with statistically significant(P < 0.05).6.Length of hospital stay and cost: The neonatal late onset GBS infection of the duration of hospital stay were(23.3±14.5)days in neonatal late onset GBS group and(24.8±19.8)days in early-onset GBS group.The costed of neonatal late onset GBS group were(62485.0 + 12739.6)yuan and(63689.6 + 17874.0)yuan.In neonatal late-onset group.the duration of hospital stay and cost had no statistical difference between two groups(P > 0.05).7 The incidence of neurological complications: encephalomalacia 4/17(23.5%),cerebral infarction,1/17(5.9%),1/17(5.9%),subdural effusion ventricle tube meningitis in 2/17(11.8%),lateral ventricle Angle empyema after 2/17(11.8%),1/17(5.9%),abnormal frontal temporal lobe 11/17 overall incidence of neurological complications(64.8%).in Neonatal late-onset GBS group,and encephalomalacia 3/18(16.7%),cerebral infarction,1/18(5.6%),1/18(5.6%),subdural effusion 5/18 overall incidence of neurological complications(27.9%).In Neonatal late-onset GBS group.Neurological complications were 64.8% VS 27.9%between two groups with statistical difference(P < 0.05).Conclusions1.The initial symptoms of neonatal late-onset GBS infection were fever and feeding intolerance,compared different with that of early-onset GBS infection.2.Neonatal late-onset GBS infection mainly fested as sepsis and meningitis.3.Family members infection of horizontal transmission played an important role in neonatal late-onset GBS infection.4.Neonatal late-onset GBS infection developed more neurologic sequelae than that of early-onset GBS infection.5.There was no difference in medical burden and bacterial resistance between neonatal late-onset and early-onset GBS infections.