Sepsis neonatal Group B Streptococcus and gram negative bacteria: prevalence and risk of meningitis

Abstract

Introduction: Sepsis and meningitis are major causes of neonatal morbidity and mortality. 

Objective: To identify the prevalence and risk of meningitis in neonates with sepsis due to group B Streptococcus (GBS) and gram-negative bacteria (GNB), and to compare risk factors, clinical and laboratory characteristics. 

Patients and Method: Cross-sectional study of 30 infants with infections due to GBS and 41 due to BGN. Data were analyzed by Stata® 11.0, using measures of central tendency and dispersion, according to their distribution, to compare differences. Categorical variables were compared using χ² test or Fisher's Exact Test and associations using prevalence ratios (PR) and odds ratio (OR) with 95% confidence interval. A level of probability of < 0.05 was used as a significance criterion. 

Results: The prevalence of meningitis among infants with sepsis was 16.9% (95% CI: 7.5-26.3 %). 33.3% (10/30) of sepsis due to GBS was associated with meningitis, while 4.9% (2/40) was associated with GNB, finding a clear connection between sepsis and meningitis in neonates with GBS (OR: 9.5; CI 95%:1.7-94.3). 80% (CI 95%: 44,4-97,5%) of cases of meningitis associated with GBS sepsis occurred in infants older than 72 hours. 

Conclusion: Meningitis was more common in infants with GBS sepsis, mainly in cases of late-onset sepsis. The association between GNB sepsis and meningitis was less frequent in early sepsis, and was not found in late sepsis.