J Korean Child Neurol Soc.  2011 Dec;19(3):208-217.

Clinical Features and Prognostic Factors of Neurologic Outcome in Group B Streptococcal Meningitis

• Cho HL
• Shin HW
• Kim KS
• Kim EY

Abstract

PURPOSE
Group B streptococcal (GBS) meningitis is the leading cause of mortality and morbidity in neonates. There are limited current data regarding outcomes from GBS meningitis and factors that predict an adverse outcome.
METHODS
Twenty-three cases of GBS meningitis that were proven by cerebrospinal fluid culture from 2000 to 2010 were retrospectively reviewed.
RESULTS
All GBS meningitis cases occurred in young infants less than 3 months and were late-onset (> or =7 days). Four infants (17.4%) died, and three (13.0%) were neurologically impaired at hospital discharge. Compared to the 16 infants with normal neurologic examinations, the 7 infants who died or had adverse outcomes at hospital discharge were more likely to present with seizures within hours of admission, have coma, require pressor support or ventilator support, have an initial peripheral blood leukocyte count less than 4,000/mm3 or neutrophil count less than 1,000/mm3, and have ampicillin resistance on culture.
CONCLUSION
Despite advances in intensive care, 30.4% of infants with GBS meningitis die or have neurologic impairment at hospital discharge. Poor outcome can be predicted in cases that have seizures, coma, peripheral leukopenia, or require ventilator or pressor support on initial presentation. These cases show a tendency toward resistance to ampicillin, so vancomycin can be tried initially.

Keyword

Streptococcus agalactiae; Meningitis; Newborn; Prognosis

MeSH Terms

Ampicillin
Ampicillin Resistance
Coma
Humans
Infant
Infant, Newborn
Critical Care
Leukocyte Count
Leukopenia
Meningitis
Neurologic Examination
Neutrophils
Prognosis
Retrospective Studies
Seizures
Streptococcus agalactiae
Vancomycin
Ventilators, Mechanical
Ampicillin
Vancomycin