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J Pediatr Infect Dis 2020; 15(04): 212-216
DOI: 10.1055/s-0040-1708810
Rapid Communication
Georg Thieme Verlag KG Stuttgart · New York

Analysis of 11 Cases of Neonatal Invasive Streptococcus pyogenes Infection

Yong-Ping Xie
1   Division of Infectious Diseases, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, P.R. China
,
Chun-Zhen Hua
1   Division of Infectious Diseases, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, P.R. China
,
Hui Yu
2   Division of Infectious Diseases, Children's Hospital of Fudan University, Shanghai, P.R. China
,
Hong-Mei Xu
3   Division of Infectious Diseases, Children's Hospital of Chongqing Medical University, Chongqing, P.R. China
,
Wei Gao
4   Division of Infectious Diseases, Kaifeng Children's Hospital, Kaifeng, P.R. China
,
Zhi-Wei Xu
5   Division of Infectious Diseases, The Second Affiliated Hospital & Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, P.R. China
,
Ai-Wei Lin
6   Division of Infectious Diseases, Qilu Children's Hospital of Shandong University, Jinan, P.R. China
› Author Affiliations Funding None.
Further Information

Publication History

23 November 2019

21 February 2020

Publication Date:
24 March 2020 (online)

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Abstract

Objective This study aimed to improve the understanding of clinical characteristics of neonatal invasive Streptococcus pyogenes infection (iSPI).

Methods A retrospective study was performed to analyze the clinical and laboratory aspects of culture-confirmed neonatal iSPI cases during 2010 to 2017.

Results Eleven cases of neonatal iSPI were confirmed. The ages ranged from 2 hours to 26 days. Ten cases had positive blood culture results and one had positive cerebrospinal fluid culture for S. pyogenes. Seven patients had fever and seven had identified focal infection, including six skin and soft tissue infections and one case of pneumonia. All of the S. pyogenes strains were sensitive to penicillin, cefotaxime, and vancomycin, and nine were resistant to clindamycin and erythromycin. Six patients received penicillin or cephalosporin monotherapy. Three patients received meropenem plus vancomycin initially, and then two of them were switched to penicillin and one to vancomycin after pathogen identification. Two cases were treated with vancomycin monotherapy. All cases were discharged after being cured or showing improvement.

Conclusion Skin and soft tissue infection is a common manifestation of neonatal iSPI. Streptococcus pyogenes strains are highly sensitive to β-lactams, which should be used as the first-choice treatment.

Keywords

Streptococcus pyogenes - group A Streptococcus - neonate - invasive infection

Conclusion

Further study is needed to determine if there were any common emm types associated with invasive neonatal disease.


Ethical Statement

This study was approved by the ethics committee and the Institutional Board of Privacy and Security at the hospitals (2018-IEC-047).


Data Availability

The data used to support the findings of this study are available from the corresponding author upon request.


 

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