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Clinical features and outcomes of community‐acquired late‐onset sepsis: Focusing on group B Streptococcus and Escherichia coli
Author(s) -
Yun Ki Wook,
Park Sun Hyung,
Cho Eun Young,
Lee Hyunju
Publication year - 2019
Publication title -
pediatrics international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.49
H-Index - 63
eISSN - 1442-200X
pISSN - 1328-8067
DOI - 10.1111/ped.14012
Subject(s) - medicine , meningitis , pleocytosis , streptococcus agalactiae , group b , sepsis , escherichia coli , streptococcus , retrospective cohort study , cerebrospinal fluid , microbiology and biotechnology , neonatal meningitis , pediatrics , gastroenterology , bacteria , biology , biochemistry , gene , genetics
Background Group B Streptococcus (GBS) and Escherichia coli are leading causes of late‐onset sepsis (LOS) and bacterial meningitis in neonates and infants. This study aimed to describe clinical characteristics and outcomes of community‐acquired (CA) LOS caused by GBS and E. coli . Methods A retrospective observational study was performed in three university hospitals in Korea. All infants aged <90 days who were diagnosed with GBS or E coli CA‐LOS from 2011 to 2017 were enrolled. Data on the clinical characteristics and outcomes of GBS and E. coli CA‐LOS were compared. Results Forty GBS and 43 E. coli CA‐LOS cases were identified, which mostly (82/83) included term or near‐term infants. Meningitis was identified in 54.1% of GBS CA‐LOS cases and in 30.3% of E. coli CA‐LOS cases, and 88.4% of E. coli CA‐LOS cases involved urosepsis. Ten percent each of GBS and non‐uropathogenic E. coli (non‐UPEC) meningitis cases and all uropathogenic E. coli (UPEC) meningitis cases were diagnosed by pleocytosis without bacterial growth in the cerebrospinal fluid (CSF). Patients with non‐culture‐proven meningitis had lower CSF pleocytosis and protein levels and higher CSF/serum glucose ratios than patients with culture‐proven meningitis ( P < 0.05 for all). One patient died of CA‐LOS, which was accompanied by meningitis with extended‐spectrum β‐lactamase‐producing non‐UPEC. Neurological complications developed in 22.5% of GBS CA‐LOS cases and in 2.3% of E. coli CA‐LOS cases. Conclusions Neurological complications were frequently observed in GBS CA‐LOS cases, although no mortality was observed. Escherichia coli CA‐LOS generally developed as urosepsis, which caused non‐culture‐proven meningitis and had a favorable outcome.