Group B streptococcal infections in children in a tertiary care hospital in southern Taiwan

Group B Streptococcus (GBS) is widely recognized as a leading cause of neonatal sepsis and meningitis. Recently, GBS infections in older children have been increasingly noted. This retrospective study investigated the clinical features, distribution of serotypes, and antimicrobial susceptibility of GBS isolates in a tertiary care center in southern Taiwan over a 12-year period. GBS isolates recovered from various infected sites in 54 children treated from June 1991 through December 2002 were studied. These children were divided into those with disease onset of up to 3 months of age (group 1) and those with disease onset after 3 months of age (group 2). Patients in group 1 were subdivided into early-onset disease (EOD, <7 days of age, 7/30) and late-onset disease (LOD, ≥7 days to 3 months of age, 23/30). Sepsis (90% vs 8%; p<0.01) and meningitis (40% vs 4.2%; p<0.01) were observed more frequently in group 1, whereas urinary tract infection (UTI; 45.8% vs 6.7%; p<0.01) and acute tonsillitis (33.3% vs 0%; p<0.01) were noted more frequently in group 2. Underlying conditions were more common in group 2 than in group 1 (50% vs 10%; p<0.01), especially in patients with UTI. The most frequently encountered serotype was serotype III (56%). Patients in group 1, especially those with LOD, and those who had meningitis or sepsis, were prone to develop serotype III infections (p<0.05). All isolates were susceptible to penicillin G and cephalothin. About 50% of isolates were susceptible to erythromycin, azithromycin, and to clindamycin. In conclusion, GBS infection in children has different characteristics in different age groups. Serotype III is the most prevalent serotype in children. GBS isolates in southern Taiwan are still very susceptible to penicillin G.