The changing spectrum of Group B streptococcal (GBS) infection in infants of Saudi Arabia

This study describes the incidence, clinical presentation and outcome of ne onatal Group B streptococcal (GBS) infection in a Saudi Arabian Hospital. C harts of all neonates with GBS infection admitted to our hospital during a 5-year period (1990-1994) were reviewed retrospectively. Of the 29,601 live births, 23 neonates had GBS infection, giving an overall incidence rate of 0.8 per 1000 live births. The incidence rate appeared to increase from 0.2 per 1000 live births in 1990 to 1.2 per 1000 live births in 1994 (not stat istically significant (P=0.07)). Of the 23 neonates with GBS infection, 16 (70%) were full term infants (gestation greater than or equal to 37 weeks). In contrast, 7 (30%) were preterm infants (gestation <37 weeks). Ten (44%) mothers had premature rupture of membrane. Intrapartum fever and/or urinar y tract infection was observed in 9% of the mothers. Nineteen (82%) of the neonates had early onset GBS infection, whereas only 4 infants (18%) had la te-onset infection. Blood and CSF cultures were positive in 21 (91%) and 5 (21%), respectively. Complications of GBS infection were as follows: sepsis without focus of infection 15 (65%); meningitis 5 (22%); pneumonia 3 (13%) ; urinary tract infection 2 (9%), None of these complications had any signi ficant association with the onset of infection (P>0.1). The overall case-fa tality rate was 9%. The incidence of GBS infection appears to be increasing in Saudi neonates a nd measures to prevent perinatal transmission need to emphasized and implem ented.