Group B streptococcal meningitis: Cerebrospinal fluid parameters in the era of intrapartum antibiotic prophylaxis

Objective: Describe cerebrospinal fluid parameters in infants with culture-proven Group B streptococcal meningitis in the era of intrapartum antibiotic prophylaxis. Study design: Cohort Study of the first lumbar puncture from 13,495 infants cared for at 150 neonatal intensive care units. We compared cerebrospinal fluid parameters [white blood cell count, red blood cell count, glucose, and protein], demographics, and Outcomes between infants with and without Group B streptococcal meningitis. Results: We identified 46 infants with Group B streptococcal meningitis. The median cerebrospinal fluid white blood cell count was 271 cells/mm(3) for infants with Group B streptococcal meningitis and 6 cells/mm(3) for infants Without meningitis (p = 0.0001). Of the infants with Group B streptococcal meningitis, 9/46 (20%) had negative blood Cultures. Meningitis complicated 22/145 (15%) of episodes of early-onset Group B streptococcal sepsis and 13/23 (57%) of episodes of late-onset Group B Streptococcal sepsis. Conclusions: Group B streptococcal meningitis Occurs in the presence of negative blood Cultures. In hospitalized infants who undergo a lumbar Puncture, Group B streptococcal sepsis is frequently complicated by GBS meningitis. (C) 2009 Elsevier Ireland Ltd. All Fights reserved.