Neonatal Late-Onset Meningitis Caused by Serotype III CC17 Group B Streptococci Aggregating in Two Families from Southern China

Background: Late-onset meningitis infected by group B Streptococcus (GBS) continues to be a major cause of perinatal mortality, morbidity and long-term neurodevelopmental sequelae despite the implementation of universal screening, but its risk factors are not fully understood.Case Presentation: We reported a set of dizygotic twins and a pair of compatriot siblings diagnosed with late-onset GBS meningitis aggregating in two Chinese families. All of GBS strains were identified as serotype III CC17 with high homology between the strains within the same family, and the isolates from the compatriots identical to their mother's carriage. The siblings in the two families presented clinical signs several days after close contact with their index cases having a fever at home, and obtained prompt diagnosis and anti-infective therapy. The two index patients had obvious brain damage before effective treatment and severe sequelae compared to their siblings with complete healing.Conclusion: The dramatic difference in outcomes between the index cases and their siblings brings attention to prevent and control familial aggregation of neonatal late-onset GBS infection which never reported in China.

Automated summary

Late-onset Group B Streptococcus (GBS) meningitis occurred in two Chinese families, involving a set of dizygotic twins and a pair of compatriot siblings. GBS strains of serotype III CC17 were identified with high homology within each family, and the siblings' isolates matched their mother's carriage. The siblings developed symptoms days after close contact with their index cases, but received prompt diagnosis and treatment, resulting in better outcomes compared to the index patients who had brain damage and severe sequelae.