EARLY ONSET GROUP B STREPTOCOCCAL DISEASE. SEVEN YEAR EXPERIENCE AND CLINICAL SCORING SYSTEM

Abstract

Early onset group B streptococcal disease was reviewed for the period 1975-1981 at Vanderbilt University Medical Center [Tennessee, USA]; 120 cases were identified. The disease varied from asymptomatic bacteremia to fatal cardiopulmonary collapse. Factors associated with a poor outcome were prematurity, low Apgar score at 5 min, the presence of shock, leukopenia, rupture of membranes for > 12 and a delay in treatment after the onset of symptoms. A scoring system for probability of death based on these 6 factors was then developed. Over the 7 yr period, mortality decreased from 50 to 10%. The only factor identified with the decrease in mortality was a significant decrease in the number of hours between the onset of symptoms and the beginning of treatment. Early recognition and prompt treatment seem to be the major causes of the decreasing mortality over the 7 yr of this report.