Early neonatal bacteraemia. Comparison of group B streptococcal, other Gram-positive and Gram-negative infections

Abstract

All cases of neonatal bacteraemia associated with clinical illness occurring at Hammersmith Hospital, over a 9-year period, 1967-1975 inclusive, have been reviewed. The infants studied were those born in the hospital's maternity unit and those admitted from other hospitals from a wide area round London who were ill or of low birthweight. Positive blood cultures occurred in 91 infants, 47 of them in the first 48 hours of life. These 47 infants were analysed separately and divided into three groups, 13 with group B streptococcal infections, 11 with other Gram-positive infections, and 23 with Gram-negative infections. There were no significant differences in birthweight or gestation, in mortality, in incidence of clinically diagnosed respiratory distress syndrome or recurrent apnoea, or in the need for mechanical ventilation between the three groups. The age at which a diagnosis of infection was suspected, and the age at death were both significantly earlier in the group infected with group B streptococcus than in those obtained with other organisms (P less than 0-01 for both comparisons). There were no significant differences in the incidence of hyaline membrane formation or pneumonia seen at necropsy among the three groups. In some of the earliest deaths in the Gram-negative bacteraemic group, Gram-negative rods comprised the bulk of the hyaline membrane as did cocci in the group B streptoccal group.