Late-onset and Recurrent Neonatal Group B Streptococcal Disease Associated with Breast-milk Transmission

SAGE Publications - Tập 6 Số 3 - Trang 251-256 - 2003
Michael Kotiw1, Gwang W. Zhang1, Grant Daggard1, Elizabeth Reiss‐Levy2, John W. Tapsall3, Andrew Numa4
1Center for Biomedical Research, Department of Biological and Physical Sciences, Faculty of Sciences, University of Southern Queensland, Toowoomba, Queensland, Australia 4350
2South East Area Laboratory Services, St. George Hospital, Sydney, New South Wales, Australia
3South East Area Laboratory Services, Prince of Wales Hospital, Sydney, New South Wales, Australia
4Intensive Care Unit, Sydney Children's Hospital, Sydney, New South Wales, Australia

Tóm tắt

The purpose of the study was to determine the epidemiological relationships in three unrelated cases of neonatal late-onset Group B streptococcal (GBS) disease and maternal breast-milk infection with GBS. All deliveries were by cesarean section; case 1 was at term, and cases 2 and 3 were at 32- and 33-wk gestation, respectively. Case 1 relates to a mother with clinical mastitis and recurrent GBS infection in a 20-day-old male infant. Following antibiotic therapy and cessation of breastfeeding, the infant recovered without sequelae. Case 2 refers to a mother with clinical mastitis and the occurrence of late-onset GBS disease in 5-wk-old male twins. Despite intervention, one infant died and the second became ill. Following antibiotic therapy and cessation of breast-feeding, the surviving infant recovered without sequelae. Case 3 refers to a mother with sub-clinical mastitis and late-onset GBS infection occurring in a 6-day-old female twin. Following intervention, the infant recovered but suffered a bilateral thalamic infarction resulting in developmental delay and a severe seizure disorder. Following recovery of GBS from an inapparent mastitis and cessation of breast-feeding, the second infant remained well. Blood cultures from all affected infants and maternal breast milk were positive for GBS. Epidemiological relationships between neonatal- and maternal-derived GBS isolates were confirmed by a random amplified polymorphic DNA polymerase chain reaction assay (RAPD-PCR). This study is significant in that it has demonstrated that maternal milk (in cases of either clinical or sub-clinical mastitis) can be a potential source of infection resulting in either late-onset or recurrent neonatal GBS disease.

Từ khóa


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SAGE Publications

Tập 6 Số 3

251-256

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