Benzylpenicillin (Penicillin G)
M. Lindsay Grayson, Sara E. Cosgrove, Suzanne M. Crowe, M. Lindsay Grayson, William Hope, James S. McCarthy, John Mills, Johan W. Mouton, David L. Paterson in Kucers’ The Use of Antibiotics, 2017
Streptococcus agalactiae is usually carried in the lower intestinal tract, and in the perineum and vagina of females (Anthony, 1982; Dillon et al., 1982; Easmon, 1986; Persson et al., 1987). It is a potentially serious cause of neonatal infections (McCracken, 1973; Berg et al., 1977; Cowen, 1979; Hamoudi and Hamoudi, 1981; Persson et al., 1986) but has also been implicated in certain adult infections, such as septicemia, diabetic foot infections, and meningitis (Anthony and Concepcion, 1975; Gallagher and Watanakunakorn, 1986; Verghese et al., 1986; Aharoni et al., 1990; Back et al., 1990; Dunne and Quagliarello, 1993; Sarmiento et al., 1993). There is a 30-fold increased risk of S. agalactiae infection in patients with diabetes mellitus, cancer, or HIV infection (Farley et al., 1993; Wessels and Kasper, 1993). Rare cases have been reported with classical toxic shock–like syndrome, in which the patient is not bacteremic, but urine and vaginal cultures grow group B streptococci that elaborate a pyrogenic toxin (Schlievert et al., 1993).
Medicines in neonates
Evelyne Jacqz-Aigrain, Imti Choonara in Paediatric Clinical Pharmacology, 2021
During the last few decades, the organisms responsible for neonatal early-onset sepsis have changed very little since Streptococcus agalactiae and Escherichia coli represent the major causative pathogens [20]. On the other hand, coagulase negative staphylococci, most often methicillin resistant, have steadily increased as the primary cause of late-onset neonatal septicaemia and invasive infections. However, a recent survey has indicated that there may be an increase in multi-resistant E. coli as the leading causative agent of early onset septicaemia in VLBW infants [21]. This increase in multi-resistant E.coli may be related to the increase in use of broad-spectrum antibiotics during labour and delivery. Regarding late-onset sepsis, some recent reports have shown an emerging number of cases where gram negative bacilli have been found as the causative agent [22]. These findings regarding changes in the bacteria responsible for infectious diseases in the neonate are of concern. These preliminary findings need confirmation, but it shows that this problem cannot be solved by a more aggressive antibiotic regimen with even broader spectrum antibiotics. Moreover, these reports should motivate perinatologists to use a more rational approach with narrow-spectrum antibiotics and an optimal antibiotic combination [23]. In addition, implementing good clinical practice procedures and guidelines in each intensive care unit is needed. Among those measures, consequent hand washing by care providers and isolating and cohorting the patients colonised with multi-resistant bacteria should be reinforced [24].
Infections of the Genital Systems
Keith Struthers in Clinical Microbiology, 2017
The newborn child is at risk of infection arising from acquisition of organisms from the normal vaginal flora, importantly Streptococcus agalactiae and Escherichia coli. These bacteria can colonize the upper airways of the newborn, with the potential to invade and cause neonatal sepsis and meningitis. Listeria monocytogenes can cross from the bowel of the expectant mother, usually in the third trimester, and can cause maternal sepsis, chorioamnionitis and miscarriage. Reaching the fetus from the maternal blood or during birth, it can also cause neonatal sepsis and meningitis.
Bacterial meningitis: new treatment options to reduce the risk of brain damage
Published in Expert Opinion on Pharmacotherapy, 2020
Nicola Principi, Susanna Esposito
Bacterial meningitis (BM) is a medical emergency and its etiology varies significantly according to the age group and geographic area [1–3]. Most of the cases are due to Streptococcus pneumoniae, Neisseria meningitidis, and Haemophilus influenzae type b (Hib). However, in neonates and younger infants, owing to the role played by maternal pathogens, a great number of cases are due to Streptococcus agalactiae, Gram-negative intestinal rods, including Escherichia coli, and Listeria monocytogenes. In people older than 50 years, together with traditional bacteria, even L. monocytogenes is a relatively common aetiologic agent of BM. Staphylococcus aureus and Mycobacterium tuberculosis occasionally occur,but are generally observed in patients with risk factors for infections due to these pathogens. Rarer, although increased in recent years, are cases due to multidrug resistant agents such as Klebsiella spp. and Acinebacteria spp.
Prevalence and risk factors of group B Streptococcus colonisation in intrapartum women: a cross-sectional study
Published in Journal of Obstetrics and Gynaecology, 2019
Wandee Akkaneesermsaeng, Chusana Petpichetchian, Mingkwan Yingkachorn, Saranya Sasithorn
Streptococcus agalactiae (group B Streptococcus, GBS) is a gram-positive bacterium colonised in the genitourinary and gastrointestinal tracts of pregnant women with varying prevalence that ranges from 2.3 to 32.9% (Lim et al. 1986; Adair et al. 2003; Orret 2003; Kovavisarach et al. 2007; Namavar et al. 2008; Sharmila et al. 2011; Turner et al. 2012; Woldu et al. 2014). Neonates may be infected by GBS during vaginal birth causing neonatal sepsis, pneumonia, and meningitis which make GBS the leading cause of neonatal morbidity and mortality in developed countries (Verani et al. 2010; Stoll et al. 2011; Edmond et al. 2012). Early-onset GBS disease (EOGBS), defined as infection caused by GBS which occurs during the first week of life, is a serious neonatal condition with an overall incidence of 0.37 per 1000 live births and case fatality ratio of 4–6% (Verani et al. 2010).
Incidence of invasive Group B Streptococcus (iGBS) infections and the factors associated with iGBS mortality in adults during 2013–2017: a retrospective study at Thailand’s largest national tertiary referral center
Published in Annals of Medicine, 2021
Pakpoom Phoompoung, Nantaporn Pirogard, Amornrut Leelaporn, Nasikarn Angkasekwinai
Streptococcus agalactiae, which is commonly referred to as Group B Streptococcus (GBS), remains the leading cause of neonatal sepsis and postpartum infection in both high and low-income countries [1–3]. Over the last 2 decades, GBS has also emerged as an important cause of invasive disease in nonpregnant adults [4–7]. The increase in the incidence of invasive GBS (iGBS) disease was largest among older adult patients and those with underlying medical conditions, particularly diabetes mellitus [7]. The clinical spectrum of iGBS disease varies substantially, ranging from mild to severe life-threatening illness depending on host factors and the site and extent of the infection [3,4,7]. Sequence type (ST) 283 was found to be more commonly associated with meningoencephalitis, septic arthritis, and spinal infection in a large outbreak in Singapore [8]. The mortality rate also varies widely with a reported range of 8.9–19% [3,9,10]. Previous studies of iGBS in adults mainly focussed on pregnant women or were reported from high-income countries [11–13]. Studies of iGBS disease in non-pregnant adults from low-to-middle-income countries (LMICs) are scarce [3,10]. Improved understanding of the current epidemiology of iGBS disease and the factors associated with iGBS mortality will improve prevention, treatment, and outcomes.
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