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Early-Onset Neonatal Sepsis: Group B Streptococcal Compared to E. coli Disease

Renoldner B, Hofer N and Resch B

Background: Early onset sepsis (EOS) of the newborn is a severe disease and associated with high morbidity and mortality. Aim of the study was to compare perinatal, short-term outcome and laboratory data of neonates with early-onset sepsis (EOS) either due to Group B Streptococci (GBS) or Escherichia coli (E. coli) infection.
Methods: Retrospective cohort analysis of all neonates with culture proven GBS and E. coli EOS born between 1993 and 2011 and hospitalized at the NICU of the Medical University of Graz, Austria. Data were analyzed regarding perinatal, laboratory and short-term outcome data.
Results: During the study period 100 neonates with EOS due to GBS and 11 neonates with E. coli infection were hospitalized at our NICU. Perinatal and short-term outcome data differed between GBS and E. coli infection regarding gestational age (median 38 vs. 32 weeks, p=.005), birth weight (median 3095 vs. 1836 grams, p=.031), presence of hypothermia (0 vs. 18%, p=.009), duration of mechanical ventilation (4 vs. 8 days, p=.019), duration of therapy with supplemental oxygen (9 vs. 2 days, p=.031), length of hospitalization (15 vs. 22 days, p=.039), presence of chorioamnionitis (17 vs. 46%, p=.041) and maternal fever (2 vs. 18%, p=.049). Mortality rates did not differ significantly (6 vs. 18%, p=.180). Laboratory data regarding white blood cell count, IT-ratio, and CRP value were not different between groups within the first 72 hours of life. There was a significant decrease of GBS sepsis during the study period (p=0,014). Conclusion: Main differences between GBS and E. coli infections were due to higher rates of preterm birth in the E. coli group, clinical and laboratory characteristics only differed marginally.