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Recurrent group B stretococcus infection in an extremely premature infant: as a preterm neonate, infant and toddler

Lookup NU author(s): Dr Christo TsilifisORCiD, Dr Eleri Williams

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Abstract

© BMJ Publishing Group Limited 2023. No commercial re-use. See rights and permissions. Published by BMJ.We report five discrete episodes of group B streptococcus (GBS) bacteraemia in an extremely premature infant, extending into early childhood. The first four episodes occurred during infancy despite appropriate treatment. Breastmilk was positive for group B streptococcal 16S DNA by polymerase chain reaction. The fifth episode occurred at 17 months of age, shortly after stopping antimicrobial prophylaxis. Radiological investigations did not identify a focus for recurrence of GBS bacteraemia, and immunological investigations and targeted whole genome sequencing yielded only transient hypogammaglobulinaemia of infancy, which resolved. This case highlights invasive GBS infection as a cause of infant morbidity. Premature infants are at particular risk of invasive as well as recurrent disease. GBS is typically a sensitive organism and each episode of GBS in our patient was effectively treated with penicillin. The role of breastmilk in recurrent GBS is controversial; in this case infant and mother isolated identical GBS serotypes and were concurrently treated with rifampicin.

Publication metadata

Author(s): Van Der Loeff IS, Tsilifis C, Abdelhafiz K, Williams EJ

Publication type: Article

Publication status: Published

Journal: BMJ Case Reports

Year: 2023

Volume: 16

Issue: 7

Print publication date: 28/07/2023

Online publication date: 28/07/2023

Acceptance date: 23/06/2023

ISSN (electronic): 1757-790X

Publisher: BMJ Publishing Group

URL: https://doi.org/10.1136/bcr-2023-255216

DOI: 10.1136/bcr-2023-255216

PubMed id: 37507127

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