Abstract
Group A streptococci (GAS) have previously accounted for a large portion of invasive neonatal infections, but differences in the access to medical care and in the antibiotic used over the last half century has significantly reduced such cases. A literature review reveals 17 neonatal GAS meningitis reports with positive CSF cultures since 1967, characterized by high morbidity and mortality. We present a case of a 10-day old well-appearing neonate diagnosed with GAS meningitis, exhibiting an excellent response to antimicrobial therapy. Epidemiological investigation revealed her mother as the likely source of postnatal transmission of GAS with an emm1.0 subtype. GAS meningitis is a rare cause of neonatal meningitis associated with high morbidity and mortality warranting further research assessing potential risk factors, modes of transmission, and therapeutic protocols.
Similar content being viewed by others
Abbreviations
- CDC:
-
Centers for disease control and prevention
- CSF:
-
Cerebrospinal fluid
- GAS:
-
Group a streptococcus
- SIADH:
-
Syndrome of inappropriate antidiuretic hormone secretion
References
Lardhi AA. Neonatal group a streptococcal meningitis: a case report and review of the literature. Cases J. 2008;1:1–4. https://doi.org/10.1186/1757-1626-1-108.
De Almeida Torres RSL, Fedalto LE, De Almeida Torres RF, et al. Group a streptococcus meningitis in children. Pediatr Infect Dis J. 2013;32:110–4. https://doi.org/10.1097/INF.0b013e31826fd4af.
Miyairi I, Berlingieri D, Protic J, Belko J. Neonatal invasive group a streptococcal disease: case report and review of the literature. Pediatr Infect Dis J. 2004;23:161–5. https://doi.org/10.1097/01.inf.0000109887.40636.07.
Coulter JB, Buchannon CR, Vellodi A, et al (1984) Group-a streptococcal infection in the newborn. Lancet (London, England) 2:355–6.
Verboon-Maciolek MA, Krediet TG, Van Ertbruggen I, et al. Severe neonatal group a streptococcal disease. Eur J Pediatr. 2000;159:450–2. https://doi.org/10.1007/s004310051305.
Hmami F, Oulmaati A, Mahmoud M, Boubou M, Tizniti S, Bouharrou A. Méningite néonatale à streptocoque a et thrombose porte: Une association fortuite? Arch Pediatr. 2014;21:1020–3. https://doi.org/10.1016/j.arcped.2014.06.007.
Annagür A. A rare cause of neonatal meningitis: group a streptecocci. Dicle Med J / Dicle Tıp Derg. 2013;40:118–20. https://doi.org/10.5798/diclemedj.0921.2013.01.0236.
El Youssi H, Touaoussa A, Deham H, et al. Méningite à streptocoque du groupe A chez le nouveau né: à propos d’un cas. Pan Afr Med J. 2015;20:2–5. https://doi.org/10.11604/pamj.2015.20.374.6141.
Panchatcharam BS. Group a streptococcal meningitis in a neonate from a tertiary care Centre. Univ J Pre Paraclin Sci. 2017;2.
Dillon HC. Group a type l2 streptococcal infection in a newborn nursery. Am J Dis Child. 1966;112:177–84. https://doi.org/10.1001/archpedi.1966.02090120045002.
Nelson JD, Dillon HC, Howard JB. A prolonged nursery epidemic associated with a newly recognized type of group a streptococcus. J Pediatr. 1976;89:792–6. https://doi.org/10.1016/S0022-3476(76)80809-8.
Nutman J, Henig E, Wilunsky E, Reisner SH. Acute necrotising fasciitis due to streptococcal infection in a newborn infant. Arch Dis Child. 1979;54:637–9.
Baumgartner ET. Bacterial meningitis in older neonates. Arch Pediatr Adolesc Med. 1983;137:1052. https://doi.org/10.1001/archpedi.1983.02140370014005.
Murphy DJ (1983) Group a streptococcal meningitis. Pediatrics 71:1 LP – 5.
Krebs VLJ, Chieffi LN, Ceccon MEJR, et al. Meningite neonatal por streptococcus pyogenes e trombose de seio sagital: Relato de caso. Arq Neuropsiquiatr. 1998;56:829–32. https://doi.org/10.1590/S0004-282X1998000500021.
Nelson GE, Pondo T, Toews K-A, Farley MM, Lindegren ML, Lynfield R, et al. Epidemiology of invasive group a streptococcal infections in the United States, 2005–2012. Clin Infect Dis. 2016;63:478–86. https://doi.org/10.1093/cid/ciw248.
Hasbun R, Wootton SH, Rosenthal N, Balada-Llasat JM, Chung J, Duff S, et al. Epidemiology of meningitis and encephalitis in infants and children in the United States, 2011–2014. Pediatr Infect Dis J. 2019;38:37–41. https://doi.org/10.1097/INF.0000000000002081.
de RSLA T, Dos Santos TZ, de RAA T, et al. Management of Contacts of patients with severe invasive group a streptococcal infection. J Pediatric Infect Dis Soc. 2015;5:47–52. https://doi.org/10.1093/jpids/piu107.
The Prevention of Invasive Group A Streptococcal Infections Workshop Participants. Prevention of invasive group a streptococcal disease among household contacts of case patients and among postpartum and postsurgical patients: recommendations from the Centers for Disease Control and Prevention. Clin Infect Dis. 2002;35:950–9. https://doi.org/10.1086/342692.
Lardhi AA. Neonatal group a streptococcal meningitis: a case report and review of the literature. Cases J. 2008;1:1–4. https://doi.org/10.1186/1757-1626-1-108.
Leonard A, Wright A, Saavedra-Campos M, et al. Severe group a streptococcal infections in mothers and their newborns in London and the south east, 2010–2016: assessment of risk and audit of public health management. BJOG An Int J Obstet Gynaecol. 2019;126:44–53. https://doi.org/10.1111/1471-0528.15415.
Garges HP. Neonatal meningitis: what is the correlation among cerebrospinal fluid cultures, blood cultures, and cerebrospinal fluid parameters? Pediatrics. 2006;117:1094–100. https://doi.org/10.1542/peds.2005-1132.
Greenberg RG, Benjamin DK, Cohen-Wolkowiez M, et al. Repeat lumbar punctures in infants with meningitis in the neonatal intensive care unit. J Perinatol. 2011;31:425–9. https://doi.org/10.1038/jp.2010.142.
Imöhl M, Fitzner C, Perniciaro S, Van Der Linden M. Epidemiology and distribution of 10 superantigens among invasive Streptococcus pyogenes disease in Germany from 2009 to 2014. PLoS One. 2017;12:1–14. https://doi.org/10.1371/journal.pone.0180757.
Tuerlinckx D, Gueulette E, Loens K, Goossens H, Smeesters PR. Group a streptococcal meningitis: emm type distribution and theoretical vaccine coverage in children. Acta Clin Belg. 2016;71:138–41. https://doi.org/10.1179/2295333715Y.0000000066.
Gherardi G, Vitali LA, Creti R. Prevalent emm types among invasive GAS in Europe and North America since year 2000. Front Public Heal. 2018;6:59. https://doi.org/10.3389/fpubh.2018.00059.
Funding
There is no funding source.
Author information
Authors and Affiliations
Contributions
T.T.: Conceived and drafted the manuscript, performed literature search and article selection. E.M.: Collected patient clinical data and aided in article selection and review. E.N.: Collected and analyzed microbiological data presented in the study. A.L.: Reviewed the manuscript, supervised article selection and review, approved final draft of the manuscript.
Corresponding author
Ethics declarations
Conflict of Interest
The authors declare that they have no conflict of interest.
Ethical Approval
This article does not contain any studies with human participants or animals performed by any of the authors.
Informed Consent
Informed consent was obtained from all individual participants included in the study.
Additional information
Publisher’s Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
This article is part of the Topical Collection on Medicine
Rights and permissions
About this article
Cite this article
Talmy, T., Mazor, E., Nasser, E. et al. Neonatal Group A Streptococcus Meningitis. Case Report and Literature Review. SN Compr. Clin. Med. 2, 472–477 (2020). https://doi.org/10.1007/s42399-020-00255-7
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s42399-020-00255-7